Provider Demographics
NPI:1629842406
Name:PRIOLO, JOSEPH (LCADC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PRIOLO
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CHARLES BOSSERT DR
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2751
Mailing Address - Country:US
Mailing Address - Phone:732-900-9054
Mailing Address - Fax:
Practice Address - Street 1:51 CHARLES BOSSERT DR
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2751
Practice Address - Country:US
Practice Address - Phone:732-900-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00372000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)