person
Cory S Divine, CSAC,LPC
Addiction (Substance Use Disorder) Counselor in Madison, Wisconsin
NPI 1558494211

Cory S Divine is an Addiction (Substance Use Disorder) Counselor based in Madison, WI and is specialized in Addiction (Substance Use Disorder). Cory S Divine practices in Madison, WI and has the professional credentials of CSAC,LPC. The NPI Number for Cory S Divine is 1558494211 and holds a License No. 6901-125 (Wisconsin).

The current practice location address for Cory S Divine is 6402 Odana Rd Ste 106, Madison, WI and can be reached out via phone at 608-220-8627.

Location: 6402 Odana Rd Ste 106, Madison, WI, 53719-1123
person
Provider Profile Details
NPI Number
1558494211
Provider Name
Cory S Divine
Credential
CSAC,LPC
Provider Entity Type
Individual
Gender
Male
Address
6402 Odana Rd Ste 106, Madison, WI, 53719-1123
Phone Number
608-220-8627
Fax Number
Provider Enumeration Date
03/13/2007
Last Update Date
01/18/2025
institution
Provider Business Practice Location Address Details
Address
6402 Odana Rd Ste 106
City
State
Zip
53719-1123
Phone Number
608-220-8627
Fax Number
person
Provider Business Mailing Address Details
Address
6402 Odana Rd Ste 106
City
State
Zip
53719-1123
Phone Number
608-220-8627
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
15367-132 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
6901-125 (Wisconsin)
Definition
Definition to come...
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