Provider Demographics
NPI:1336357466
Name:CORCORAN, CAROL HILDEGARD (LCMFT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:HILDEGARD
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 RITCHIE HWY
Mailing Address - Street 2:SUITE 100 #245
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2325
Mailing Address - Country:US
Mailing Address - Phone:443-254-0686
Mailing Address - Fax:410-349-3677
Practice Address - Street 1:1521 RITCHIE HWY
Practice Address - Street 2:SUITE 100 #245
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2703
Practice Address - Country:US
Practice Address - Phone:443-254-0686
Practice Address - Fax:410-349-3677
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM146106H00000X
AZLMFT-15453106H00000X
COMFT.0001806106H00000X
CAMFC38043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist