Provider Demographics
NPI:1073823373
Name:WOLPERT, JOAN F (MA, BC-DMT, LPC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:F
Last Name:WOLPERT
Suffix:
Gender:F
Credentials:MA, BC-DMT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 SHEFFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3727
Mailing Address - Country:US
Mailing Address - Phone:610-608-1470
Mailing Address - Fax:
Practice Address - Street 1:1060 FIRST AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1336
Practice Address - Country:US
Practice Address - Phone:610-992-0555
Practice Address - Fax:610-992-1010
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional