Provider Demographics
NPI:1275854309
Name:CORSE, PATRICIA B (LAPC, NCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:CORSE
Suffix:
Gender:F
Credentials:LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 CORNELL AVE STE 3A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2757
Mailing Address - Country:US
Mailing Address - Phone:912-354-7447
Mailing Address - Fax:912-354-7448
Practice Address - Street 1:1149 CORNELL AVE STE 3A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2757
Practice Address - Country:US
Practice Address - Phone:912-354-7447
Practice Address - Fax:912-354-7448
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001996101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor