| Cordell Associates, Llc | |
|
6520 Poe Ave Ste 200 Dayton OH 45414-2856 | |
| (937) 276-3356 | |
| (937) 276-9514 |
| Full Name | Cordell Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6520 Poe Ave Ste 200, Dayton, Ohio |
| Authorized Official Name and Position | Marcy J Gunn (OWNER) |
| Authorized Official Contact | 9372763356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cordell Associates, Llc 6500 Poe Ave Ste 400 Dayton OH 45414-2527 Ph: (937) 276-3356 | Cordell Associates, Llc 6520 Poe Ave Ste 200 Dayton OH 45414-2856 Ph: (937) 276-3356 |
| NPI Number | 1780735597 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 10/11/2022 |
| Certification Date | 10/11/2022 |
| Medicare PECOS PAC ID | 8325130453 |
|---|---|
| Medicare Enrollment ID | O20070822000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780735597 | NPI | - | NPPES |
| 0140207 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5179 (Ohio) | Primary |
| Provider Name | Marcy J Gunn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881743177 PECOS PAC ID: 9032204730 Enrollment ID: I20070926000616 |
| Provider Name | Anthony L Rivers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982982963 PECOS PAC ID: 8022262831 Enrollment ID: I20130201000443 |
| Provider Name | Erika Fontana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972767085 PECOS PAC ID: 7113091372 Enrollment ID: I20180926004242 |
| Provider Name | Jonathan M Cleveland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568910974 PECOS PAC ID: 5991045239 Enrollment ID: I20190322000838 |
| Provider Name | Devon Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366959751 PECOS PAC ID: 7315342565 Enrollment ID: I20210825004011 |
| Provider Name | Stephen Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316058878 PECOS PAC ID: 9335547611 Enrollment ID: I20211018002456 |
| Provider Name | Chelsae Roby Pistello |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215338249 PECOS PAC ID: 5092151902 Enrollment ID: I20240314001268 |
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