Provider Demographics
NPI:1356609721
Name:CATHERINE CORBETT LCSW LLC
Entity type:Organization
Organization Name:CATHERINE CORBETT LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-918-0146
Mailing Address - Street 1:245 DUNTON CT
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4550
Mailing Address - Country:US
Mailing Address - Phone:847-918-0146
Mailing Address - Fax:847-918-0747
Practice Address - Street 1:10 W PHILLIP RD
Practice Address - Street 2:SUITE 107
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1799
Practice Address - Country:US
Practice Address - Phone:847-918-0146
Practice Address - Fax:847-918-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0094411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty