Provider Demographics
NPI:1235439662
Name:DICESARE, JOSEPH VICTOR
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:VICTOR
Last Name:DICESARE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOEY
Other - Middle Name:VICTOR
Other - Last Name:DICESARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:104 1/2 N MARIETTA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1255
Mailing Address - Country:US
Mailing Address - Phone:740-695-5441
Mailing Address - Fax:740-695-6747
Practice Address - Street 1:104 1/2 N MARIETTA ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1255
Practice Address - Country:US
Practice Address - Phone:740-695-5441
Practice Address - Fax:740-695-6747
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0701015104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker