Provider Demographics
NPI:1649915299
Name:ABALLO, CORINNE (NCC, LPC)
Entity type:Individual
Prefix:MISS
First Name:CORINNE
Middle Name:
Last Name:ABALLO
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 JOHN MCGUCKIN DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7751
Mailing Address - Country:US
Mailing Address - Phone:732-598-4811
Mailing Address - Fax:
Practice Address - Street 1:219 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3255
Practice Address - Country:US
Practice Address - Phone:204-290-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00960700101Y00000X
NJ37AC00524900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor