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General NPI Number Information
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NPI Number | 1356609721
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Entity Type | Organization
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Legal Business Name | CATHERINE CORBETT LCSW LLC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 10 W PHILLIP RD SUITE 107
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City | VERNON HILLS
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State | IL
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Zip | 60061-1799
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Country | US
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Telephone | 847-918-0146
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Fax | 847-918-0747
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Provider Business Mailing Address
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Address Line | 245 DUNTON CT
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City | MUNDELEIN
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State | IL
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Zip | 60060-4550
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Country | US
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Telephone | 847-918-0146
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Fax | 847-918-0747
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Authorized Official
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Title or Position | OWNER
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Name | MS. CATHERINE A CORBETT
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Credential | LCSW
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Telephone | 847-918-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149-009441
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License Number State | IL
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