Provider Demographics
NPI:1861615361
Name:CORBIN, JERI L (ATR-BC,LPC)
Entity type:Individual
Prefix:MS
First Name:JERI
Middle Name:L
Last Name:CORBIN
Suffix:
Gender:F
Credentials:ATR-BC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SANDALWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-1544
Mailing Address - Country:US
Mailing Address - Phone:412-429-0944
Mailing Address - Fax:
Practice Address - Street 1:309 SANDALWOOD CT
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-1544
Practice Address - Country:US
Practice Address - Phone:412-429-0944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health