Provider Demographics
NPI:1649741307
Name:ALLEN, JOSEPH JR (MPA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 NEEDHAM STREET
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460
Mailing Address - Country:US
Mailing Address - Phone:774-203-4671
Mailing Address - Fax:
Practice Address - Street 1:223 NEEDHAM STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460
Practice Address - Country:US
Practice Address - Phone:774-203-4671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health