Provider Demographics
NPI:1659730224
Name:CARRICO, JOSEPH KEVIN (LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KEVIN
Last Name:CARRICO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CLIFFORD E HARBOURT DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3311
Mailing Address - Country:US
Mailing Address - Phone:210-995-2246
Mailing Address - Fax:
Practice Address - Street 1:16 CLIFFORD E HARBOURT DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3311
Practice Address - Country:US
Practice Address - Phone:210-995-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00533800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional