Provider Demographics
NPI:1124196837
Name:CORBETT, CATHERINE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:A
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:CORBETT
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 DUNTON CT
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4550
Mailing Address - Country:US
Mailing Address - Phone:847-918-0146
Mailing Address - Fax:847-918-0747
Practice Address - Street 1:10 W PHILLIP RD
Practice Address - Street 2:SUITE 107
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1799
Practice Address - Country:US
Practice Address - Phone:847-918-0146
Practice Address - Fax:847-918-0747
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490094411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
04932076OtherBLUE CROSS