Provider Demographics
NPI:1477798916
Name:CORBETT, CYNTHIA ELISE (LICSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ELISE
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 ROCK ST
Mailing Address - Street 2:JUVENILE COURT CLINIC
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3244
Mailing Address - Country:US
Mailing Address - Phone:508-676-0090
Mailing Address - Fax:508-674-3295
Practice Address - Street 1:289 ROCK ST
Practice Address - Street 2:JUVENILE COURT CLINIC
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3244
Practice Address - Country:US
Practice Address - Phone:508-676-0090
Practice Address - Fax:508-674-3295
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10296781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical