Provider Demographics
NPI:1033411954
Name:DONNA J CORBETT LCSW AND ASSOCIATES
Entity Type:Organization
Organization Name:DONNA J CORBETT LCSW AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-815-1442
Mailing Address - Street 1:17 SYLVAN ST
Mailing Address - Street 2:103 A
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2037
Mailing Address - Country:US
Mailing Address - Phone:201-815-1442
Mailing Address - Fax:201-372-1151
Practice Address - Street 1:17 SYLVAN ST
Practice Address - Street 2:103 A
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2037
Practice Address - Country:US
Practice Address - Phone:201-815-1442
Practice Address - Fax:201-372-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051688001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty