Provider Demographics
NPI:1649565060
Name:SELDESS, JOSEPH (JOE) ROBERT (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH (JOE)
Middle Name:ROBERT
Last Name:SELDESS
Suffix:
Gender:M
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 BRUMMEL ST.
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3874
Mailing Address - Country:US
Mailing Address - Phone:847-869-2370
Mailing Address - Fax:
Practice Address - Street 1:1014 BRUMMEL
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3874
Practice Address - Country:US
Practice Address - Phone:847-869-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy