Corey Douglas
Individual provider Active NPI Professional Counselor · Franklin, OH
NPI 1336736230 · NPPES record last updated Dec 25, 2020
Key facts
- NPI
- 1336736230
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 252491 (KY)
- Practice address
- 712 East 2ND St
6891
Franklin, OH 45005 - Phone
- (937) 516-1957
- NPI assigned
- Dec 25, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252491 | KY | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 252491 | KY | Yes |
Addresses
Primary practice location
712 East 2ND St
6891
Franklin, OH 45005
Mailing address
PO Box 6891
Franklin, OH 45005-6891
Other providers in Franklin, OH
- Nzinga Gbea Davis
- Dana Leanne Demmitt
- Amanda Kaye Deskins
- Katherine Dimario
- Doctors Urgent Care Offices Medical Group Inc
- Joseph Downey
- Dr Weston R Mangold, LLC
- Lianna Duchardt
- Stephen C Durham
- Dva Healthcare Southwest Ohio LLC
All providers in Franklin, OH · Professional Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.