Provider Demographics
NPI:1114590130
Name:KESSEL, JOSEPH B (MED, LAC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:KESSEL
Suffix:
Gender:M
Credentials:MED, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD STE B5
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3536
Mailing Address - Country:US
Mailing Address - Phone:445-444-0460
Mailing Address - Fax:
Practice Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD STE B5
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3536
Practice Address - Country:US
Practice Address - Phone:445-444-0460
Practice Address - Fax:609-890-0265
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00544700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health