MR. CORVELL COBURN LCSW, RN
NPI 1124559232
Social Worker - Clinical in Hattiesburg, MS

Active since March 22, 2017
262 KING RD, HATTIESBURG, MS 39402(662) 769-1024 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 18, 2020, Mar 29, 2017, Mar 22, 2017 (3 updates tracked since 2017).

About Mr. Corvell Coburn Lcsw, Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CORVELL COBURN LCSW, RN (NPI 1124559232) is an individual clinical provider in Hattiesburg, Mississippi, licensed in Mississippi (C11412) and active in the NPI registry since March 2017.

NPPES Registry Identity

NPI1124559232
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. CORVELL COBURNCredential: LCSW, RN
Location Address262 KING RDHattiesburg, MS 39402-8503
Mailing Address262 King RdHattiesburg, MS 39402-8503 · (662) 769-1024
Sole ProprietorYes
Enumeration DateMarch 22, 2017
Last NPPES UpdateJanuary 24, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2025
NPI 1124559232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MS · C11412
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 906622 (MS)
262 KING RD, Hattiesburg, MS 39402

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Adult Mental Health)
262 KING RD
HATTIESBURG, MS 39402

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Corvell Coburn's NPI number?

The NPI number for Corvell Coburn is 1124559232. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Corvell Coburn located?

Corvell Coburn practices at 262 King Rd, Hattiesburg, MS 39402. The listed phone number is (662) 769-1024.

What is Corvell Coburn's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Corvell Coburn was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.