Provider Demographics
NPI:1770010357
Name:CORRIE, JANELLE (LCSW, CPC)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:CORRIE
Suffix:
Gender:F
Credentials:LCSW, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 STERLING PL APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4554
Mailing Address - Country:US
Mailing Address - Phone:845-489-3084
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE # CD238
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty