Individual
CORY LODER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
25 COTTAGE ST, BRIEN CENTER MAIN ST. HUMAN RESOURCES, GREAT BARRINGTON, MA 01230-1329
(413) 528-9155
Mailing address
9 MILLER VIEW ROAD, NORTH EGREMONT, MA 01252
(413) 528-9285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106296
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31711
HEALTH NEW ENGLAND
MA
01
—
P04922
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/23/2007
Last updated
07/08/2007
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