Provider Demographics
NPI:1033482914
Name:CORCORAN, JOSEPHINE M (LCMHC)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:M
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:CORCORAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC
Mailing Address - Street 1:20 W CANAL ST
Mailing Address - Street 2:SUITE C/2
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2131
Mailing Address - Country:US
Mailing Address - Phone:802-654-7600
Mailing Address - Fax:802-654-7601
Practice Address - Street 1:20 W CANAL ST
Practice Address - Street 2:SUITE C/2
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2131
Practice Address - Country:US
Practice Address - Phone:802-654-7600
Practice Address - Fax:802-654-7601
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0057599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health