Individual provider Active NPI

Merina Corby, PHD, LMFT

  • Marriage & Family Therapist
  • New London, CT
National Provider Identifier
1104035286
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001255 Issued in CT
Practice address
125 Shaw St
New London, CT 06320-4900
Phone
(860) 912-7105
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X CT
Marriage & Family Therapist 106H00000X 001255 CT Primary

Addresses

Primary practice location

125 Shaw St
New London, CT 06320-4900

Mailing address

27 Masonic St Unit 1693
New London, CT 06320-7768
Phone (860) 912-7105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001255CTMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1104035286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MASONIC ST UNIT 1693",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063207768",
            "telephone_number": "860-912-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SHAW ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204900",
            "telephone_number": "860-912-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBY",
        "first_name": "MERINA",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.