Provider Demographics
NPI:1770263980
Name:CORBETT, TIFFANI DENEEN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:TIFFANI
Middle Name:DENEEN
Last Name:CORBETT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6281 ROHNS ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-2654
Mailing Address - Country:US
Mailing Address - Phone:313-772-1924
Mailing Address - Fax:
Practice Address - Street 1:6281 ROHNS ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-2654
Practice Address - Country:US
Practice Address - Phone:313-772-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011053711041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical