Provider Demographics
NPI:1366644437
Name:COMMUNICATION CORNER
Entity type:Organization
Organization Name:COMMUNICATION CORNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TESSANDORI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC CLP
Authorized Official - Phone:270-691-2699
Mailing Address - Street 1:2200 E PARRISH AVE STE 105C
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1450
Mailing Address - Country:US
Mailing Address - Phone:270-691-2699
Mailing Address - Fax:270-691-6277
Practice Address - Street 1:2200 E PARRISH AVE STE 105C
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1450
Practice Address - Country:US
Practice Address - Phone:270-691-2699
Practice Address - Fax:270-691-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1707251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1255437174Medicare UPIN
KY1376620245Medicare UPIN