Provider Demographics
NPI:1356654883
Name:JOSEPH, ALTON EDWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALTON
Middle Name:EDWARD
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-0518
Mailing Address - Country:US
Mailing Address - Phone:302-396-1588
Mailing Address - Fax:302-396-0409
Practice Address - Street 1:20155 OFFICE CIRCLE, SUITE 2
Practice Address - Street 2:GEORGETOWN PROFESSIONAL PARK
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947
Practice Address - Country:US
Practice Address - Phone:302-396-1588
Practice Address - Fax:302-396-0409
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE20100629122101YP1600X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health