Provider Demographics
NPI:1306402540
Name:KERSTETTER, JOSEPH (LSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KERSTETTER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 RENAISSANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2781
Mailing Address - Country:US
Mailing Address - Phone:484-803-9663
Mailing Address - Fax:484-393-4096
Practice Address - Street 1:5034 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2022
Practice Address - Country:US
Practice Address - Phone:609-837-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06216700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker