Provider Demographics
NPI:1043629868
Name:CORBIN, CYNTHIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CORBIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 WINGATE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2830
Mailing Address - Country:US
Mailing Address - Phone:215-681-3713
Mailing Address - Fax:215-333-1270
Practice Address - Street 1:4402 WINGATE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2830
Practice Address - Country:US
Practice Address - Phone:215-681-3713
Practice Address - Fax:215-333-1270
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW0142861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical