Provider Demographics
NPI:1366454019
Name:EPSTEIN, JOEL J (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:J
Last Name:EPSTEIN
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 1:1480 GULF BLVD
Mailing Address - Street 2:#502
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2876
Mailing Address - Country:US
Mailing Address - Phone:727-596-1346
Mailing Address - Fax:
Practice Address - Street 1:587 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6256
Practice Address - Country:US
Practice Address - Phone:727-796-4623
Practice Address - Fax:727-466-0818
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3549103T00000X, 103G00000X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75586OtherBLUE CROSS/BLUE SHIELD
FLR00071Medicare UPIN
FL75586Medicare ID - Type Unspecified