Provider Demographics
NPI:1235463159
Name:JOSEPH, CARRIE S (LPCMH)
Entity Type:Individual
Prefix:MISS
First Name:CARRIE
Middle Name:S
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N JAMES ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3182
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 N JAMES ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-3182
Practice Address - Country:US
Practice Address - Phone:302-507-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000474101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional