Provider Demographics
NPI:1548146103
Name:ACREE, CORDILIA (LCSW)
Entity type:Individual
Prefix:
First Name:CORDILIA
Middle Name:
Last Name:ACREE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11180 ASHCRAFT LOOP UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-6063
Mailing Address - Country:US
Mailing Address - Phone:915-346-7747
Mailing Address - Fax:
Practice Address - Street 1:11180 ASHCRAFT LOOP UNIT A
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-6063
Practice Address - Country:US
Practice Address - Phone:915-346-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040188981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical