Healthcare Provider Details

I. General information

NPI: 1982515805
Provider Name (Legal Business Name): KRISTINA CORBIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 W COUNTY ROAD 70
DOTHAN AL
36305-5030
US

IV. Provider business mailing address

1812 W COUNTY ROAD 70
DOTHAN AL
36305-5030
US

V. Phone/Fax

Practice location:
  • Phone: 334-791-9521
  • Fax:
Mailing address:
  • Phone: 334-791-9521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7005C
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: