Individual
MR. JAMES DARRELL CORNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
289 INDEPENDENCE BLVD, SUITE 138, VIRGINIA BEACH, VA 23462-5493
(757) 437-6142
Mailing address
941 BAJA CT, VIRGINIA BEACH, VA 23456-4279
(757) 721-0347
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701000889
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270277
ANTHEM
VA
01
—
O88050
OPTIMA
VA
Enumeration date
10/24/2006
Last updated
07/09/2007
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