Provider Demographics
NPI:1770995334
Name:CORSON, KATHRYN I (MSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CORSON
Suffix:I
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15531 HAMPTON CREST TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2917
Mailing Address - Country:US
Mailing Address - Phone:804-739-7168
Mailing Address - Fax:
Practice Address - Street 1:15531 HAMPTON CREST TER
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-2917
Practice Address - Country:US
Practice Address - Phone:804-739-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical