Provider Demographics
NPI:1962648741
Name:CORBETT, RICHARD E (LMHC/LADC-I)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:CORBETT
Suffix:
Gender:M
Credentials:LMHC/LADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ARNOLD ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-5602
Mailing Address - Country:US
Mailing Address - Phone:781-641-1642
Mailing Address - Fax:
Practice Address - Street 1:12 ARNOLD ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-5602
Practice Address - Country:US
Practice Address - Phone:781-641-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-27
Last Update Date:2008-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10101YA0400X
MA102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000LM0146OtherBCBSMA