Warren Corson III, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001465 Issued in CT

Practice address

53 Muir Ave
Bristol, CT 06010-7215

Phone

(860) 582-7904

Fax

(860) 582-4350

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Community Counseling Center of Central CT Inc

  • Professional Counselor
  • Bristol, CT
  • NPI 1760541510
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1205097243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 MUIR AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107215",
            "telephone_number": "860-582-7904",
            "fax_number": "860-582-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 MUIR AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107215",
            "telephone_number": "860-582-7904",
            "fax_number": "860-582-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "WARREN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raechaell Corbett, MS OTR/L
• Marissa Corry
• Julie Ann Corsino, LCSW
• Lisa Corson, LPC
• Warren Corson IV
• Elizabeth Anne Costello, RPH
• Septimiu Cozmuta
• James F Craig, DC
• Olivia Elise Cratty
• Anna J Cronin, DPT

• Professional Counselor in Bristol, CT
• Providers in Bristol, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.