# CENTER FOR TRAUMA RECOVERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Trauma Recovery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841969094
- **Authorized official:** CHARLES J. CORBALLY LICSW (CO OWNER)
- **Authorized official phone:** (802) 281-3330

## Contact information

- **Practice address:** 523 SMUGGLERS VIEW RD, JEFFERSONVILLE, VT 05464-9450
- **Practice address phone:** (802) 324-3792
- **Mailing address:** 523 SMUGGLERS VIEW RD, JEFFERSONVILLE, VT 05464-9450
- **Mailing address phone:** (802) 324-3792

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2021
- **Last updated:** 09/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1028428 | — | VT |