Provider Demographics
NPI:1194855387
Name:KORBEL, MURIEL DELIGHT (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MURIEL
Middle Name:DELIGHT
Last Name:KORBEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:MURIEL
Other - Middle Name:DELIGHT
Other - Last Name:KORBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:10 JANNOR WAY
Mailing Address - Street 2:W.YARMOUTH
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-3456
Mailing Address - Country:US
Mailing Address - Phone:508-790-7070
Mailing Address - Fax:508-778-8581
Practice Address - Street 1:30 HIGGINS CROWELL RD
Practice Address - Street 2:
Practice Address - City:W YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-3444
Practice Address - Country:US
Practice Address - Phone:508-778-1213
Practice Address - Fax:508-778-8581
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10262661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA012567OtherMBHP
MAP20832Medicaid
MAP20832Medicaid