Provider Demographics
NPI:1467617241
Name:FLINT, JOSEPH L (LCPC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:L
Last Name:FLINT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 SHERMAN AVE # 105
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4421
Mailing Address - Country:US
Mailing Address - Phone:773-919-0317
Mailing Address - Fax:
Practice Address - Street 1:1555 SHERMAN AVE # 105
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4421
Practice Address - Country:US
Practice Address - Phone:773-919-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional