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

Tia Cornwall, EDS, LPA

Individual provider School Psychologist · NPI 1710488408

Tia Cornwall, EDS, LPA is a School Psychologist in Shallotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2018.

Licensed in
NC
In the registry since
2018
Specialties on file
2

Practice location Address checks out

4902 Main St Ste D
Shallotte, NC 28470-4749
Phone: (910) 754-2289
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Child & Adolescent Psychologist (primary) Taxonomy 103TC2200X · Licence 6811 (NC)
School Psychologist Taxonomy 103TS0200X · Licence 1244890 (NC)

Record details

NPI number1710488408
Entity typeIndividual (Type 1)
GenderFemale
Credentials EDS , LPA
Sole proprietorNo
NPI enumeratedFebruary 27, 2018
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026