| Charles Corbally Pllc | |
|
2 Church St Ste 3g Burlington VT 05401-4457 | |
| (802) 281-3330 | |
| (802) 540-8199 |
| Full Name | Charles Corbally Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2 Church St Ste 3g, Burlington, Vermont |
| Authorized Official Name and Position | Charles J. Corbally (SOLE OWNER) |
| Authorized Official Contact | 8022813330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Corbally Pllc 2 Church St Ste 3g Burlington VT 05401-4457 Ph: (802) 281-3330 | Charles Corbally Pllc 2 Church St Ste 3g Burlington VT 05401-4457 Ph: (802) 281-3330 |
| NPI Number | 1063921740 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063921740 | NPI | - | NPPES |
| 1028428 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 089.0117025 (Vermont) | Primary |
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