Individual provider Active NPI

Kenneth Francis Corbin, LCSW

  • Clinical Social Worker
  • Lindenhurst, NY
National Provider Identifier
1457869208
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070854 Issued in NY
Practice address
26 E Minerva Rd
Lindenhurst, NY 11757-6819
Phone
(631) 416-4308
NPI assigned
Jan 15, 2018
Last updated
Jan 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 070854 NY Primary

Addresses

Primary practice location

26 E Minerva Rd
Lindenhurst, NY 11757-6819

Mailing address

26 E Minerva Rd
Lindenhurst, NY 11757-6819
Phone (631) 416-4308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201123000473 NY Practitioner - Clinical Social Worker 7214348358 Reassigns benefits to 1 organization
Practice locations: Amityville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

188 D Park Ave
Suite 3
Amityville, NY 11701-2706
Phone 63176612401240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Therapy Is Self Discovery Liscensed Clinicalsocial Worker P.C. Current Accepting new patients
Nassau Guidance Counseling & Licensed Clinical Social Work Services PC Clinical CurrentSince Apr 8, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kennethcorbin@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1457869208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 E MINERVA RD",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117576819",
            "telephone_number": "631-416-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 E MINERVA RD",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117576819",
            "telephone_number": "631-416-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "KENNETH",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.