Individual provider Active NPI

Maura Kathleen Cornell, LPC

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1275772246
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
60583 Issued in TX
Practice address
9708 Skillman St
Dallas, TX 75243-5150
Phone
(214) 684-7881
NPI assigned
Feb 13, 2009
Last updated
Feb 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 60583 TX Primary

Addresses

Primary practice location

9708 Skillman St
Dallas, TX 75243-5150

Mailing address

8260 San Cristobal Dr
Dallas, TX 75218-4432
Phone (214) 684-7881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103003606 TX Practitioner - Mental Health Counselor 0446601447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Psychological Development IncGroup PAC ID 5395929384, 28 clinicians

Practice addresses (Care Compare)

1105 Memorial Dr
Suite 202
Denison, TX 75020-2043
Phone (903) 337-0343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60583TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Psychological Development, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1105 Memorial Dr
Ste 202
Denison, TX 75020
Phone (903) 337-0343

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1275772246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 SAN CRISTOBAL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184432",
            "telephone_number": "214-684-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9708 SKILLMAN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435150",
            "telephone_number": "214-684-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "MAURA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "60583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.