Roger L. Corbin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19198 Issued in FL

Practice address

900 N Swallow Tail Dr Ste 105
Port Orange, FL 32129-6103

Phone

(386) 333-9717

NPI assigned

Apr 29, 2019

Last updated

Jan 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, MA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roger@lakesidetherapists.com

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MA

  Medicare reassignment Care Compare group NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Clinical, MA

  Medicare reassignment Care Compare group NPD
• Patricia Adams Counseling, LLC

  dba Lakeside Counseling and Wellness Center

  • Mental Health Counselor
  • Port Orange, FL
  • NPI 1578951596

  Clinical

  Medicare reassignment NPD
• Valera Medical, P.a.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1871248757

  Clinical, FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1891359402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N SWALLOW TAIL DR STE 105",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296103",
            "telephone_number": "386-333-9717",
            "fax_number": "386-333-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N SWALLOW TAIL DR STE 105",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296103",
            "telephone_number": "386-333-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "ROGER",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19198",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "SW126527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roger@Lakesidetherapists.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "900 N Swallow Tail Dr Ste 105",
            "city": "Port Orange",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321296103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Cooper, RBT
• Coquina Cay Assisted Living
• Coquina Cove Assisted Living
• Cora Health Services Inc (CORA Physical Therapy - Port Orange)
• Caroline Corasaniti
• Core Chiropractic & Spinal Rehab Center, LLC
• Core Counseling Service Inc
• Laurette Cornel, ARNP
• Cornerstone Caregiving East LLC
• Renee Corns

• Clinical Social Worker in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.