Healthcare Provider Details

I. General information

NPI: 1770995334
Provider Name (Legal Business Name): KATHRYN CORSON I MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E MAIN ST STE 216
RICHMOND VA
23223-7073
US

IV. Provider business mailing address

3024 CONE MANOR LN
RALEIGH NC
27613-6604
US

V. Phone/Fax

Practice location:
  • Phone: 804-620-7434
  • Fax:
Mailing address:
  • Phone: 804-620-7434
  • Fax: 919-348-2751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: