Provider Demographics
NPI:1518043850
Name:CORBETT, DARLENE M (MSW)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:M
Last Name:CORBETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 GREAT PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2565
Mailing Address - Country:US
Mailing Address - Phone:781-444-3559
Mailing Address - Fax:781-453-9853
Practice Address - Street 1:1040 GREAT PLAIN AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2565
Practice Address - Country:US
Practice Address - Phone:781-444-3559
Practice Address - Fax:781-453-9853
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW10607111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
717557OtherTUFTS
P04855OtherBC
717557OtherTUFTS