Provider Demographics
NPI:1689749467
Name:FELEPPA, JOSEPH G (LISW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:FELEPPA
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 GREENPOND RD
Mailing Address - Street 2:
Mailing Address - City:GRAY COURT
Mailing Address - State:SC
Mailing Address - Zip Code:29645-5062
Mailing Address - Country:US
Mailing Address - Phone:864-575-3323
Mailing Address - Fax:864-575-3323
Practice Address - Street 1:101 PELHAM COMMONS BLVD.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-9997
Practice Address - Country:US
Practice Address - Phone:864-275-3419
Practice Address - Fax:864-241-6682
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q3108891272Medicare ID - Type Unspecified