Provider Demographics
NPI:1043362460
Name:CORBIN, BRANDI (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CORBIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:VAINIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW-C
Mailing Address - Street 1:515 SNOWS COVE RD
Mailing Address - Street 2:
Mailing Address - City:SEDGWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04676-3437
Mailing Address - Country:US
Mailing Address - Phone:207-322-5466
Mailing Address - Fax:
Practice Address - Street 1:515 SNOWS COVE RD
Practice Address - Street 2:
Practice Address - City:SEDGWICK
Practice Address - State:ME
Practice Address - Zip Code:04676-3437
Practice Address - Country:US
Practice Address - Phone:207-322-5466
Practice Address - Fax:207-629-9083
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC117171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432313499Medicaid