Provider Demographics
NPI:1316354061
Name:MCCORVEY, SAMUEL HIRAM (LCSW -R)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:HIRAM
Last Name:MCCORVEY
Suffix:
Gender:
Credentials:LCSW -R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529-35 WILLIAMSBRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-9991
Mailing Address - Country:US
Mailing Address - Phone:718-794-8504
Mailing Address - Fax:
Practice Address - Street 1:1529 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2502
Practice Address - Country:US
Practice Address - Phone:718-794-8504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR072216-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool