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Organization
TRACY W CORBETT, LCSW, PC
Active
Organization
TRACY W CORBETT, LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY WOSKE CORBETT LCSW (CEO)
(229) 460-0663
Entity
Organization
Contact information
Practice address
1013 CHERRY CREEK DR, VALDOSTA, GA 31605-5922
(229) 460-0663
Mailing address
1013 CHERRY CREEK DR, VALDOSTA, GA 31605-5922
(229) 460-0663
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002825
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11733902
CAQH
GA
Enumeration date
07/08/2012
Last updated
07/08/2012
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