DR. WARREN III CORSON (PH.D.) – Professional Counselor, NPI 1205097243

DR. WARREN III CORSON (PH.D.) is a healthcare provider. based in Bristol, Connecticut. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials PH.D.. They hold a License No. 001465 (CT). The NPI Number for DR. WARREN III CORSON (PH.D.) is 1205097243

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. WARREN III CORSON (PH.D.)
NPI
1205097243
Phone
(860) 582-7904
Address
53 MUIR AVE
Enumeration Date
23 June 2008
Last Update Date
23 June 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2038799485
Graduation Year
2006 (20 years ago)
PAC ID
9335587641
Group Practice PAC ID
8820436892
Professional Enrollment ID
I20240423001654
Address ID
CT067162123WO1089XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

818 MENTAL HEALTH COUNSELOR in CT

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Provider Addresses for DR. WARREN III CORSON (PH.D.)

  • 53, Muir Avenue, Bristol, Hartford County, Connecticut, 06010, United States

    BRISTOL, CT 060107215

    Phone: (860) 582-7904

    Fax: (860) 582-4350

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240423001654IMental Health CounselorCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06010)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820436892View full group profile
NameSpecialtyState
Mental Health CounselorCT
Mental Health CounselorCT
Clinical Social WorkerCT

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Frequently asked questions

Where can patients find DR. WARREN III CORSON (PH.D.)'s NPI?
You can confirm DR. WARREN III CORSON (PH.D.) with NPI 1205097243; it appears in the national provider directory.
Is DR. WARREN III CORSON (PH.D.) active in the national directory?
DR. WARREN III CORSON (PH.D.)'s public NPI profile is in an active state.
Can you summarize DR. WARREN III CORSON (PH.D.)'s specialty in plain language?
Clinically, the directory lists DR. WARREN III CORSON (PH.D.) with Professional Counselor. Clinical services aligned with this taxonomy classification.
Does DR. WARREN III CORSON (PH.D.) practice in Connecticut?
You will see Bristol, Connecticut on file for DR. WARREN III CORSON (PH.D.) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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