Healthcare Provider Details

I. General information

NPI: 1912253527
Provider Name (Legal Business Name): NEVA MARIE CORVINO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NEVA MARIE ST.MORRIS

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W OLIVE AVE STE 500
BURBANK CA
91505-4572
US

IV. Provider business mailing address

2600 W OLIVE AVE STE 500
BURBANK CA
91505-4572
US

V. Phone/Fax

Practice location:
  • Phone: 747-221-9921
  • Fax:
Mailing address:
  • Phone: 805-570-0159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100299
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: