| Doctor Name: | CORY LODER |
| NPI Number: | 1336293695 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICSW |
| License Number: | 106296 |
| Business Practice Address: | 25 Cottage St Brien Center Main St. Human Resources Great Barrington, MA - 012301329 |
| Business Phone Number: | 4135289155 |
| Business Fax Number: | |
| Mailing Address: | 9 Miller View Road, NORTH EGREMONT |
| State: | MA |
| Postal Code: | 01252 |
| Phone Number: | 4135289285 |
| Fax Number: | |
| NPI Enumeration Date: | 01/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 106296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |