Provider Demographics
NPI:1144460254
Name:CORBY, CARRIE ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:CORBY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ELIZABETH
Other - Last Name:DAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:122 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6321
Mailing Address - Country:US
Mailing Address - Phone:315-732-3431
Mailing Address - Fax:
Practice Address - Street 1:122 BUSINESS PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6321
Practice Address - Country:US
Practice Address - Phone:315-732-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NY085400-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor