Provider Demographics
NPI:1093862559
Name:CORBETT, PETER MICHAEL (MSW, MED)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:MICHAEL
Last Name:CORBETT
Suffix:
Gender:M
Credentials:MSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STRONG AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3923
Mailing Address - Country:US
Mailing Address - Phone:413-586-5882
Mailing Address - Fax:
Practice Address - Street 1:2 STRONG AVE
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3923
Practice Address - Country:US
Practice Address - Phone:413-586-5882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10296061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07380Medicare UPIN
MA408501Medicare UPIN
MA234079000Medicare UPIN
MAP20837Medicare ID - Type Unspecified