Provider Demographics
NPI:1619211844
Name:CORBETT, LISA M (MSC, LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:CORBETT
Suffix:
Gender:F
Credentials:MSC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 E BELL ROAD, #2124
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-370-2669
Mailing Address - Fax:602-997-1305
Practice Address - Street 1:3344 E BEHREND DRIVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-9568
Practice Address - Country:US
Practice Address - Phone:602-456-5259
Practice Address - Fax:602-997-1305
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional