Provider Demographics
NPI:1619285681
Name:CORBETT, KELLY JO (LPC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:JO
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:JO
Other - Last Name:WILLIAMS SALERNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3498 TREAT HWY
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9763
Mailing Address - Country:US
Mailing Address - Phone:517-425-0865
Mailing Address - Fax:
Practice Address - Street 1:3486 TREAT HWY
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-9763
Practice Address - Country:US
Practice Address - Phone:517-425-0865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012128101YP2500X
MI6401019145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional