Charles Corbally PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0117025 Issued in VT

Legal business name

CHARLES CORBALLY PLLC

Practice address

2 Church St Ste 3G
Burlington, VT 05401-4457

Phone

(802) 281-3330

Fax

(802) 540-8199

NPI assigned

Sep 25, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Charles J. Corbally, LCSW

Title

Sole Owner

Phone

(802) 281-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marc D. Richter, LICSW, LADC, CADC

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1982742714
  NPD (past)

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063921740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST STE 3G",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014457",
            "telephone_number": "802-281-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST STE 3G",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014457",
            "telephone_number": "802-281-3330",
            "fax_number": "802-540-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES CORBALLY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CORBALLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "802-281-3330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0117025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028428",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Channell
• Rebecca Chapek, RN
• Rachel Moselle Charash
• William Edward Charash, M.D.
• Erica Charkalis, APRN
• Jamie Charlson, DNP, FNP-BC
• Christopher Charron
• Heejung Charron
• Christopher R Chase, M.E.
• Madison Chase, LP

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.