Provider Demographics
NPI:1285857532
Name:STOREY, JOAN E (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:STOREY
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W 96TH ST APT 23G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6269
Mailing Address - Country:US
Mailing Address - Phone:212-678-4377
Mailing Address - Fax:
Practice Address - Street 1:275 W 96TH ST APT 23G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6269
Practice Address - Country:US
Practice Address - Phone:212-678-4377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037442-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical