Provider Demographics
NPI:1609612449
Name:CORDIAL COUNSELING
Entity type:Organization
Organization Name:CORDIAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORALEA
Authorized Official - Middle Name:
Authorized Official - Last Name:DALRYMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-312-2736
Mailing Address - Street 1:1247 RUCKERBLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3630
Mailing Address - Country:US
Mailing Address - Phone:334-312-2736
Mailing Address - Fax:
Practice Address - Street 1:1247 RUCKERBLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-3630
Practice Address - Country:US
Practice Address - Phone:334-312-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty