Provider Demographics
NPI:1154472769
Name:CORBETT, ANDREW M (MC, LPCMH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:CORBETT
Suffix:
Gender:M
Credentials:MC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 STINSFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3360
Mailing Address - Country:US
Mailing Address - Phone:302-366-1328
Mailing Address - Fax:302-366-1328
Practice Address - Street 1:1201 STINSFORD RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3360
Practice Address - Country:US
Practice Address - Phone:302-366-1328
Practice Address - Fax:302-366-1328
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000068101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health