Provider Demographics
NPI:1477430767
Name:THE MENTAL CORNER, LLC
Entity type:Organization
Organization Name:THE MENTAL CORNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC
Authorized Official - Phone:334-610-7721
Mailing Address - Street 1:664 MILL POND DR
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-4703
Mailing Address - Country:US
Mailing Address - Phone:334-610-7721
Mailing Address - Fax:
Practice Address - Street 1:4411 ROSEMONT DR STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5634
Practice Address - Country:US
Practice Address - Phone:761-261-0877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty