Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TIA CORNWALL ED.S., LPA
NPI 1710488408
Psychologist in Shallotte, NC

Active since February 27, 2018
4902 MAIN ST STE D, SHALLOTTE, NC 28470(910) 754-2289 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 10, 2026, Mar 6, 2026, Feb 27, 2018 (3 updates tracked since 2018).

About Tia Cornwall Ed.s., Lpa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIA CORNWALL ED.S., LPA (NPI 1710488408) is an individual psychologist in Shallotte, North Carolina, licensed in North Carolina (6811) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1710488408
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameTIA CORNWALLCredential: ED.S., LPA
Location Address4902 MAIN ST STE DShallotte, NC 28470-4749
Mailing AddressPo Box 1023Shallotte, NC 28459-1023 · (540) 314-0606
Sole ProprietorNo
Enumeration DateFebruary 27, 2018
Last NPPES UpdateAugust 10, 20263 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
NPI 1710488408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NC · 6811
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · SchoolTaxonomy 103TS0200X · License 1244890 (NC)
4902 MAIN ST STE D, Shallotte, NC 28470

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
4902 MAIN ST STE D
SHALLOTTE, NC 28470
Psychologist
4902 MAIN ST STE D
SHALLOTTE, NC 28470

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tia Cornwall's NPI number?

The NPI number for Tia Cornwall is 1710488408. It was assigned to this individual provider in the NPPES registry on February 27, 2018.

Where is Tia Cornwall located?

Tia Cornwall practices at 4902 Main St Ste D, Shallotte, NC 28470. The listed phone number is (910) 754-2289.

What is Tia Cornwall's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Tia Cornwall was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.