Provider Demographics
NPI:1518204791
Name:KOUAME, JOEL (LCSW)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:KOUAME
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 37TH AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2112
Mailing Address - Country:US
Mailing Address - Phone:646-883-5911
Mailing Address - Fax:
Practice Address - Street 1:4601 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1784
Practice Address - Country:US
Practice Address - Phone:718-375-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker