Jeremiah Michael Corbo, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

007303 Issued in NY

Practice address

130 Morrison Ave
Staten Island, NY 10310-2944

Phone

(718) 303-2062

Fax

(888) 292-2207

NPI assigned

Jun 20, 2016

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1316397367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MORRISON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102944",
            "telephone_number": "718-303-2062",
            "fax_number": "888-292-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MORRISON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102944",
            "telephone_number": "718-303-2062",
            "fax_number": "888-292-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBO",
        "first_name": "JEREMIAH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Coppola
• Joseph Coppolo Jr., PSY.D
• Willow Vivian Copulos
• Yenny Rocio Coral, OTR/L
• Laurene Marie Corbino, CNM
• Karen Melissa Corbo
• Sally Marie Corbo, MS,PT
• Danamarie Corcoran, SLP CFY
• Constance Cordaro, PA
• Joanne Cordero-Retino, OTR/L

• Mental Health Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.