Provider Demographics
NPI:1578622684
Name:CORBETT, DENNIS CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:CHRISTOPHER
Last Name:CORBETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1787 MADISON AVE
Mailing Address - Street 2:APT 212
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-4519
Mailing Address - Country:US
Mailing Address - Phone:646-872-5341
Mailing Address - Fax:212-239-0948
Practice Address - Street 1:1787 MADISON AVE
Practice Address - Street 2:APT 212
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4519
Practice Address - Country:US
Practice Address - Phone:212-947-7111
Practice Address - Fax:212-239-0948
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0749751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY074975OtherLCSW LISCENCE