MEDICARE: CAREN CORKINS LCSW (LMSW-ACP)

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	1041C0700X	Clinical Social Worker	09631	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00413E	OTHER	TX	UNSPECIFIED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699782540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAREN CORKINS LCSW (LMSW-ACP)

Provider Business Mailing Address
First Line	:	4245 CENTERGATE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4802
Country	:	US
Telephone Number	:	210-299-2476
Fax Number	:	210-657-3095

Provider Business Practice Location Address
First Line	:	4245 CENTERGATE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4802
Country	:	US
Telephone Number	:	210-299-2476
Fax Number	:	210-657-3095

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	05/11/2015

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