Provider Demographics
NPI:1710048673
Name:CORBETT, DONNA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:J
Last Name:CORBETT
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 1:211 W 56TH ST
Mailing Address - Street 2:11K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4312
Mailing Address - Country:US
Mailing Address - Phone:212-541-7852
Mailing Address - Fax:201-372-1151
Practice Address - Street 1:211 W 56TH ST
Practice Address - Street 2:11K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4312
Practice Address - Country:US
Practice Address - Phone:212-541-7852
Practice Address - Fax:201-372-1151
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO51688001041C0700X
NY040335104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5M481Medicare PIN