Provider Demographics
NPI:1770940611
Name:RUTHERFORD, CORNA (LPCC-S)
Entity type:Individual
Prefix:MRS
First Name:CORNA
Middle Name:
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 OHIO STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501
Mailing Address - Country:US
Mailing Address - Phone:606-425-0251
Mailing Address - Fax:
Practice Address - Street 1:402 COOMER ST STE 201
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3816
Practice Address - Country:US
Practice Address - Phone:606-425-0251
Practice Address - Fax:888-892-3403
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional