Provider Demographics
NPI:1427014281
Name:PERILSTEIN, JOANNE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:P
Last Name:PERILSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 WALNUT ST
Mailing Address - Street 2:APT 16F
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4640
Mailing Address - Country:US
Mailing Address - Phone:215-564-4669
Mailing Address - Fax:
Practice Address - Street 1:1901 WALNUT ST
Practice Address - Street 2:APT 16F
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4640
Practice Address - Country:US
Practice Address - Phone:215-564-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004610L103T00000X, 103TC1900X, 103TH0100X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation