Provider Demographics
NPI:1790328029
Name:CORBETT, ERIN MELISSA (LCMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MELISSA
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MELISSA
Other - Last Name:INGRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:516 RIVER HWY STE D
Mailing Address - Street 2:PMB 198
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6830
Mailing Address - Country:US
Mailing Address - Phone:704-676-2363
Mailing Address - Fax:
Practice Address - Street 1:207 S BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-3189
Practice Address - Country:US
Practice Address - Phone:704-676-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15124101YM0800X
NCA15134101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health