Individual provider Active NPI

Tabitha Kay Corbin, LCSW

  • Clinical Social Worker
  • Waco, TX
National Provider Identifier
1396274064
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60069 Issued in TX
Practice address
2911 Herring Ave
Waco, TX 76708-3245
Phone
(214) 526-4525
Fax
(214) 520-6468
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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
Clinical Social Worker 1041C0700X 60069 TX Primary

Addresses

Primary practice location

2911 Herring Ave
Waco, TX 76708-3245

Mailing address

4305 Macarthur Ave
Dallas, TX 75209-6511
Phone (214) 526-4525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170622001114 TX Practitioner - Clinical Social Worker 9436427069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Center for Integrative Counseling and PsychologyGroup PAC ID 8527111731, 33 clinicians

Practice addresses (Care Compare)

2520 Oates Dr
Mesquite, TX 75150-1126
Phone (214) 526-4525

4305 Macarthur Ave
Dallas, TX 75209-6511
Phone (214) 526-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60069TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Integrative Counseling and Psychology CurrentSince Jun 1, 2017 Accepting new patients

Locations

4305 MacArthur Ave
Dallas, TX 75209

4525 Lemmon Ave
Ste 200
Dallas, TX 75219

2520 Oates Dr
Mesquite, TX 75150

2911 Herring Ave
Waco, TX 76708
Phone (254) 755-4410

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1396274064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 MACARTHUR AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752096511",
            "telephone_number": "214-526-4525",
            "fax_number": "214-520-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 HERRING AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083245",
            "telephone_number": "214-526-4525",
            "fax_number": "214-520-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "TABITHA",
        "middle_name": "KAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2023-07-10",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.