Provider Demographics
NPI:1164513172
Name:KORB, ROXANA E (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:ROXANA
Middle Name:E
Last Name:KORB
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MRS
Other - First Name:ROXANA
Other - Middle Name:E
Other - Last Name:RUZZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:53 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1818
Mailing Address - Country:US
Mailing Address - Phone:718-415-4429
Mailing Address - Fax:
Practice Address - Street 1:53 NOBLE ST
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1818
Practice Address - Country:US
Practice Address - Phone:718-415-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069469-11041C0700X
FLTPSW17951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY302566OtherMHN
NY000150700101OtherHEALTH PLUS
NY064971-A37OtherHEALTH FIRST
NY330632OtherWELLCARE
NY7464787OtherAETNA
NY1070480OtherAFFINITY
NYP2677456OtherOXFORD HEALTH PLAN
NY298920POtherHIP