Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jose Antonio Cordero, EDM, LAPC

Individual provider Mental Health Counselor · NPI 1720690449

Jose Antonio Cordero, EDM, LAPC is a Mental Health Counselor in Lawrenceville, Georgia. Qualified in 2018, 8 years ago. Licensed in Georgia.

Years since qualifying
8
Licensed in
GA
In the registry since
2020
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Practice location Address checks out

175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone: (678) 209-2394
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence APC007562 (GA)

Record details

NPI number1720690449
Entity typeIndividual (Type 1)
GenderMale
Credentials EDM , LAPC
Sole proprietorNo
NPI enumeratedAugust 24, 2020
Last updated in NPPESAugust 24, 2020
Certification dateAugust 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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