| Doctor Name: | MR. DEAN MARK CORCORAN |
| NPI Number: | 1740382043 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | 000053 |
| Business Practice Address: | 220 Railroad Street St. Johnsbury, VT - 05819 |
| Business Phone Number: | 8027481516 |
| Business Fax Number: | 8027481516 |
| Mailing Address: | 1423 Peacham Danville Rd, BARNET |
| State: | VT |
| Postal Code: | 058219400 |
| Phone Number: | 8027481516 |
| Fax Number: | 8027481516 |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 000053 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |