Provider Demographics
NPI:1366638082
Name:JOELSON, RICHARD B (DSW)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:JOELSON
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 87TH ST
Mailing Address - Street 2:APT. 27D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1136
Mailing Address - Country:US
Mailing Address - Phone:212-289-1612
Mailing Address - Fax:
Practice Address - Street 1:110 E 87TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4101
Practice Address - Country:US
Practice Address - Phone:212-369-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR012056-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical