Active NPI
Chanda Carmela Corbett, PHD
- Counseling Psychologist
- Ellicott City, MD
National Provider Identifier
1538219555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 04648
- Practice address
- 3545 Ellicott Mills Dr
Suite 101
Ellicott City, MD 21043-4548 - Phone
- (603) 591-0149
- Fax
- (410) 788-3220
- NPI assigned
- Jan 11, 2007
- Last updated
- May 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 04648 | MD | Primary |
Addresses
Primary practice location
3545 Ellicott Mills Dr
Suite 101
Ellicott City, MD 21043-4548
Mailing address
1108 Daniels Avernue
Gwynn Oak, MD 21207
Phone (603) 591-0149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029219200 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399852800000",
"number": "1538219555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 DANIELS AVERNUE",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "21207",
"telephone_number": "603-591-0149",
"fax_number": "410-788-3220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3545 ELLICOTT MILLS DR",
"address_2": "SUITE 101",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434548",
"telephone_number": "603-591-0149",
"fax_number": "410-788-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORBETT",
"first_name": "CHANDA",
"middle_name": "CARMELA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2014-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MD",
"license": "04648",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "029219200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.