Individual
MR. CORBIN HENNINGSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1800 NE 135TH ST STE 13, OKLAHOMA CITY, OK 73131-8001
(405) 432-0973
(405) 773-6463
Mailing address
1800 NE 135TH ST STE 13, OKLAHOMA CITY, OK 73131-8001
(405) 432-0973
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
6725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
BCBS, TRI-CARE, MAGELLAN
OK
Enumeration date
07/22/2016
Last updated
11/25/2024
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