Provider Demographics
NPI:1063509818
Name:CORBIN, CAREY ANN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:ANN
Last Name:CORBIN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 S. LEWIS AVENUE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105
Mailing Address - Country:US
Mailing Address - Phone:918-494-5021
Mailing Address - Fax:918-493-1946
Practice Address - Street 1:4870 S. LEWIS AVENUE
Practice Address - Street 2:SUITE 115
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5151
Practice Address - Country:US
Practice Address - Phone:918-494-5021
Practice Address - Fax:918-493-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health