Individual provider Active NPI

Pamela Corbin, ED.D, LPC/MHSP

  • Professional Counselor
  • Paris, TN
National Provider Identifier
1053859504
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6065 Issued in TN
Practice address
509 White St
Paris, TN 38242-3554
Phone
(731) 333-1102
NPI assigned
Feb 4, 2017
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6065 TN Primary

Addresses

Primary practice location

509 White St
Paris, TN 38242-3554

Mailing address

509 White St
Paris, TN 38242-3554
Phone (731) 333-1102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430002257 TN Practitioner - Mental Health Counselor 8921524190 Reassigns benefits to 1 organization
Practice locations: Paris, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6065TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince May 1, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

8913 Town and Country Cir
Knoxville, TN 37923
Phone (253) 861-0739

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1053859504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 WHITE ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382423554",
            "telephone_number": "731-333-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 WHITE ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382423554",
            "telephone_number": "731-333-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "PAMELA",
        "credential": "ED.D, LPC/MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-04",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "6065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

Verify at the official NPI Registry.