Provider Demographics
NPI:1033480736
Name:NINES, JOSEPH L (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:NINES
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E MILL RD
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-2027
Mailing Address - Country:US
Mailing Address - Phone:215-836-4276
Mailing Address - Fax:215-233-1081
Practice Address - Street 1:12 E MILL RD
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2027
Practice Address - Country:US
Practice Address - Phone:215-836-4276
Practice Address - Fax:215-233-1081
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000626106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist