Provider Demographics
NPI:1467475996
Name:KORSH, JOANNA BETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:BETH
Last Name:KORSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 BOSTON POST RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3534
Mailing Address - Country:US
Mailing Address - Phone:203-927-8331
Mailing Address - Fax:203-693-3195
Practice Address - Street 1:370 BOSTON POST RD
Practice Address - Street 2:SUITE 6
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3534
Practice Address - Country:US
Practice Address - Phone:203-927-8331
Practice Address - Fax:203-693-3195
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0050611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004255495Medicaid