Provider Demographics
NPI:1295010684
Name:MONAHAN, JOEL PATRICK (LMHC, CASAC)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:PATRICK
Last Name:MONAHAN
Suffix:
Gender:M
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 OSWEGO ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2446
Mailing Address - Country:US
Mailing Address - Phone:315-303-8035
Mailing Address - Fax:
Practice Address - Street 1:60 OSWEGO ST
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2446
Practice Address - Country:US
Practice Address - Phone:315-303-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25089101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health