Provider Demographics
NPI:1770936528
Name:CORBETT, KARALYN ETHEL (LCSW)
Entity type:Individual
Prefix:
First Name:KARALYN
Middle Name:ETHEL
Last Name:CORBETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SEBAGO LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2345
Mailing Address - Country:US
Mailing Address - Phone:207-590-0910
Mailing Address - Fax:
Practice Address - Street 1:212 SEBAGO LAKE RD
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2345
Practice Address - Country:US
Practice Address - Phone:207-590-0910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC168181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical