Provider Demographics
NPI:1639377765
Name:JOSEPHSON, PAUL J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:J
Last Name:JOSEPHSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:373 BLEECKER ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3261
Mailing Address - Country:US
Mailing Address - Phone:212-414-1448
Mailing Address - Fax:212-414-1448
Practice Address - Street 1:373 BLEECKER ST APT 1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3261
Practice Address - Country:US
Practice Address - Phone:212-414-1448
Practice Address - Fax:212-414-1448
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0512731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical