Provider Demographics
NPI:1639491137
Name:RINELLA, CORRINA BROOKE (LCSW)
Entity Type:Individual
Prefix:
First Name:CORRINA
Middle Name:BROOKE
Last Name:RINELLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHRISTENSEN DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-2152
Mailing Address - Country:US
Mailing Address - Phone:907-227-4306
Mailing Address - Fax:907-868-8692
Practice Address - Street 1:125 CHRISTENSEN DR # 2
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2152
Practice Address - Country:US
Practice Address - Phone:907-227-4306
Practice Address - Fax:907-868-8692
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK8561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical