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Deactivated NPI 1730272618 Deactivated / Inactive NPI Male Practitioner

Charles Cornwall , MA

Psychologist • Towanda, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Charles Cornwall has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 02, 2006
NPI Deactivation Date July 09, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Charles Cornwall, MA was a registered Psychologist practicing in Towanda, PA. Throughout an active medical career spanning 20 years, Charles Cornwall provided care at the practice location at 21 MAIN ST until profile deactivation on 2026-07-09.

Practice Location & Contact Primary Location

Practice Address

21 Main St

Towanda, PA 188481803

Telephone 5702652525
Fax 5702651075
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Towanda, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Towanda, PA (2901 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License PA PS002239L

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Edward Dugan , LCSW

Counselor - Addiction (Substance Use Disorder)

NPI 1174689194

Licensed Clinical Social Worker

Linda Mihalek , LCSW

Social Worker - Clinical

NPI 1205902459

Licensed Clinical Social Worker

Kelly Smith , LCSW

Social Worker - Clinical

NPI 1457696395

Licensed Clinical Social Worker

Patricia Kirkowski , APRN

Registered Nurse - Psychiatric/Mental Health, Adult

NPI 1528158383

Advanced Practice Registered Nurse

Rhonda Seamon , LCSW

Counselor - Addiction (Substance Use Disorder)

NPI 1790868362

Licensed Clinical Social Worker

NPI 1912081910

Licensed Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 09, 2026

Record deactivated on July 09, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 21 MAIN ST, TOWANDA, PA 188481803 (Tel: 5702652525)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 104, 202 SECOND ST., ULSTER, PA 188500104 (Tel: 5703583905)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CHARLES CORNWALL, MA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #PS002239L in PA)

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Initial NPI Registration & Enumeration October 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730272618
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 02, 2006
Last Update: July 08, 2007
Deactivation Date: July 09, 2026

Mailing Address

Po Box 104, 202 Second St.

Ulster, PA 188500104

Phone: 5703583905

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.