MEDICARE: CHARLOTTE MARIA CORBITT BCBA

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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1427724301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE MARIA CORBITT BCBA

Provider Business Mailing Address
First Line	:	301 N MAIN ST STE 2434
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101-3885
Country	:	US
Telephone Number	:	336-510-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N MAIN ST STE 2434
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101-3885
Country	:	US
Telephone Number	:	336-510-7910
Fax Number	:

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

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	01/19/2026

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Directions to “ CHARLOTTE MARIA CORBITT BCBA” Practice Location

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