Provider Demographics
NPI:1093840340
Name:CORVELEYN, AMY ELISABETH (MSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELISABETH
Last Name:CORVELEYN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARSONS DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3801
Mailing Address - Country:US
Mailing Address - Phone:978-219-9841
Mailing Address - Fax:
Practice Address - Street 1:3 PARSONS DR
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3801
Practice Address - Country:US
Practice Address - Phone:978-219-9841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1143891041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS300297137Medicaid