Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tanja Dawn Cornelison, LCPC

Individual provider Mental Health Counselor · NPI 1215188479

Tanja Dawn Cornelison, LCPC is a Mental Health Counselor in Chubbuck, Idaho. Qualified in 2005, 21 years ago. Licensed in Idaho.

Years since qualifying
21
Licensed in
ID
In the registry since
2008
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

265 E Chubbuck Rd
Chubbuck, ID 83202-5055
Phone: (208) 237-1711
Fax: (208) 237-9806
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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 LCPC-6510 (ID)

Record details

NPI number1215188479
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorNo
NPI enumeratedOctober 7, 2008
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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