Provider Demographics
NPI:1700369444
Name:GIANESIN, JOSEPH RANDALL (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RANDALL
Last Name:GIANESIN
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PINE ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1171
Mailing Address - Country:US
Mailing Address - Phone:413-549-3734
Mailing Address - Fax:
Practice Address - Street 1:97 PINE ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1171
Practice Address - Country:US
Practice Address - Phone:413-549-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1115621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical