Provider Demographics
NPI:1386181535
Name:CORBETT, JOSEY S (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEY
Middle Name:S
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3394
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32056-3394
Mailing Address - Country:US
Mailing Address - Phone:386-269-8209
Mailing Address - Fax:386-406-8340
Practice Address - Street 1:260 S MARION AVE STE 135
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-7000
Practice Address - Country:US
Practice Address - Phone:386-697-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW153951041C0700X, 1041C0700X
FLISW94441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100144500Medicaid