MEDICARE: RICHELLE CORBO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1342	CA
2	101YM0800X	Mental Health Counselor	4084	CA
3	101YM0800X	Mental Health Counselor	37PC00657000	NJ

General Provider Information

NPI Number	:	1316383235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHELLE CORBO LPC

Provider Business Mailing Address
First Line	:	36 WASHINGTON ST
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-7667
Country	:	US
Telephone Number	:	732-202-1585
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 WASHINGTON ST
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-7667
Country	:	US
Telephone Number	:	732-202-1585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2013
Last Update Date	:	07/27/2021

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Directions to “ RICHELLE CORBO LPC” Practice Location

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