Provider Demographics
NPI:1578903696
Name:FILMORE, JOEL MARC (EDD, LPCC, LCPC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MARC
Last Name:FILMORE
Suffix:
Gender:M
Credentials:EDD, LPCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-3928
Mailing Address - Country:US
Mailing Address - Phone:773-656-2738
Mailing Address - Fax:
Practice Address - Street 1:401 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3928
Practice Address - Country:US
Practice Address - Phone:773-656-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008697101YM0800X
MN899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health