Provider Demographics
NPI:1346493509
Name:NOVAK, CORRINE KATHERINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CORRINE
Middle Name:KATHERINE
Last Name:NOVAK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 E BROADWAY
Mailing Address - Street 2:#B1007
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5671
Mailing Address - Country:US
Mailing Address - Phone:212-495-9425
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:SOCIAL WORK DEPARTMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070863104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker