Tia Cornwall, EDS, LPA - Psychologist in Shallotte, NC

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Tia Cornwall, EDS, LPA is a Psychologist - Clinical Child & Adolescent based in Shallotte, North Carolina. Tia Cornwall is licensed to practice in North Carolina (license number 6811) and her current practice location is 4902 Main St Ste D, Shallotte, North Carolina. She can be reached at her office (for appointments etc.) via phone at (910) 754-2289.

NPI number for Tia Cornwall is 1710488408 and her current mailing address is Po Box 1023, Shallotte, North Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710488408.

Contact Information

Tia Cornwall, EDS, LPA
4902 Main St Ste D,
Shallotte, NC 28470-4749
(910) 754-2289
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameTia Cornwall
GenderFemale
SpecialityPsychologist - Clinical Child & Adolescent
Location4902 Main St Ste D, Shallotte, North Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1710488408
  • Provider Enumeration Date: 02/27/2018
  • Last Update Date: 03/06/2026

Medical Identifiers

Medical identifiers for Tia Cornwall such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710488408NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TS0200XPsychologist - School 1244890 (North Carolina)Secondary
103TC2200XPsychologist - Clinical Child & Adolescent 6811 (North Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tia Cornwall is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tia Cornwall, EDS, LPA
Po Box 1023,
Shallotte, NC 28459-1023

Ph: (540) 314-0606		Tia Cornwall, EDS, LPA
4902 Main St Ste D,
Shallotte, NC 28470-4749

Ph: (910) 754-2289

Reviews and Comments


Psychologist in Shallotte, NC

Mrs. Bobbi Lynn Britt, LPA, HSP-PA
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 209 Smith Ave Unit 1023, Shallotte, NC 28459
Phone: 910-736-4050    

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