Kelly M Cornish, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

77572 Issued in CA

Practice address

1740 Plum Lane
Suite B
Redlands, CA 92374

Phone

(909) 557-6574

Fax

(909) 363-9202

NPI assigned

Dec 9, 2008

Last updated

Oct 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kellie M Glassmeyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spring to Autumn Family Counseling, Inc.

  • Marriage & Family Therapist
  • Redlands, CA
  • NPI 1689056442
  NPD
• Gateway Counseling Center, Inc.

  • Marriage & Family Therapist
  • Moreno Valley, CA
  • NPI 1255449708
  NPD (past)

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1326283052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 PLUM LANE",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "909-266-7576",
            "fax_number": "909-363-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 PLUM LANE",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "909-557-6574",
            "fax_number": "909-363-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNISH",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "GLASSMEYER",
            "middle_name": "M",
            "credential": "MFT-T, MFT-I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anika Jan Coontz, LCSW
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• Karla Coppin, OT
• Linda Angelica Cornell, MSW, ACSW
• Cornerstone Family Counseling and Behavioral Health Group, Inc
• Anastacia Corona
• Bianca Correa
• Melissa Correale
• Drew Correia, R.D.
• Cortez Neurosurgery & Neurovascular Services PC (Cortez Neurosurgery & Neurovascular Services)

• Marriage & Family Therapist in Redlands, CA
• Providers in Redlands, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.