Albert Corbin Psychological Services, LLC
Organization Active NPI Clinical Psychologist · Mason, OH
NPI 1073611166 · NPPES record last updated Feb 7, 2011
Key facts
- NPI
- 1073611166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 5748 (OH)
- Legal business name
- ALBERT CORBIN PSYCHOLOGICAL SERVICES, LLC
- Practice address
- 8587 S. Mason Montgomery Rd.
Suite 9
Mason, OH 45040-9317 - Phone
- (513) 919-6722
- Fax
- (513) 282-0876
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Vicki Brault
- Title
- Business Manager
- Phone
- (513) 919-6722
Practitioners 1
-
Pamela K. Corbin, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060918000228 | OH | Part B Supplier - Clinic/Group Practice | 3476558859 |
Receives reassigned benefits from 1 practitioner Practice locations: Mason, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 5748 | OH | Yes |
Addresses
Primary practice location
8587 S. Mason Montgomery Rd.
Suite 9
Mason, OH 45040-9317
Mailing address
8587 S. Mason Montgomery Rd.
Suite 9
Mason, OH 45040-9317
Phone (513) 919-6722
Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.