Provider Demographics
NPI:1639524218
Name:JOSEPH, MAURICE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:MAURY
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:2939 VAN NESS ST NW APT 619
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4622
Mailing Address - Country:US
Mailing Address - Phone:610-368-5239
Mailing Address - Fax:202-595-1834
Practice Address - Street 1:4601 CONNECTICUT AVE NW STE 20
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5718
Practice Address - Country:US
Practice Address - Phone:610-368-5239
Practice Address - Fax:202-595-1834
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSYA00046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical