Provider Demographics
NPI:1497511778
Name:HAUGHTON, JOSEPH LIVERN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LIVERN
Last Name:HAUGHTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1954
Mailing Address - Country:US
Mailing Address - Phone:240-602-5535
Mailing Address - Fax:
Practice Address - Street 1:1338 N CAPITOL ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3396
Practice Address - Country:US
Practice Address - Phone:240-602-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator