Individual provider Active NPI

Elizabeth Ann Corbin, LCSW

  • Clinical Social Worker
  • Skowhegan, ME
National Provider Identifier
1073988010
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC17067 Issued in ME
Practice address
60 Water Street; Suite 202
Skowhegan, ME 04976
Phone
(207) 431-0494
Fax
(207) 474-5244
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC15735 ME
Clinical Social Worker 1041C0700X LC17067 ME Primary

Addresses

Primary practice location

60 Water Street; Suite 202
Skowhegan, ME 04976

Mailing address

426 Malbons Mills Rd.
Skowhegan, ME 04976
Phone (207) 431-0494

Other identifiers 1

IdentifierTypeStateIssuer
MC15735MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20180917000926 ME Practitioner - Clinical Social Worker 2466703301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Behavioral Healthcare LLCGroup PAC ID 7214097740, 29 clinicians

Practice addresses (Care Compare)

32 College Ave
Waterville, ME 04901-6100
Phone (207) 680-2065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC15735MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Behavioral Healthcare, LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

157 Park St
Ste 5
Bangor, ME 04401
Phone (207) 992-0410

222 Saint John St
Ste 113
Portland, ME 04102
Phone (207) 772-2440

32 College Ave
Ste 206
Waterville, ME 04901
Phone (207) 680-2065

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1073988010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MALBONS MILLS RD.",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "04976",
            "telephone_number": "207-431-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WATER STREET; SUITE 202",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "04976",
            "telephone_number": "207-431-0494",
            "fax_number": "207-474-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC15735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MC15735",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.