Provider Demographics
NPI:1538316161
Name:CORCORAN, MARIANNE Y (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:Y
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARIANNE
Other - Middle Name:L
Other - Last Name:YELVINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:739 S ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2747
Mailing Address - Country:US
Mailing Address - Phone:847-903-1707
Mailing Address - Fax:
Practice Address - Street 1:2015 S ARLINGTON HEIGHTS RD STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4150
Practice Address - Country:US
Practice Address - Phone:847-903-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical