Provider Demographics
NPI:1093922247
Name:JOSLIN, SERENA DAWN (LPA)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:DAWN
Last Name:JOSLIN
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 OLD NAPLES RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-8600
Mailing Address - Country:US
Mailing Address - Phone:828-505-2273
Mailing Address - Fax:828-681-1764
Practice Address - Street 1:170 OLD NAPLES RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-8600
Practice Address - Country:US
Practice Address - Phone:828-684-4228
Practice Address - Fax:828-681-1764
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3396103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107494Medicaid