Provider Demographics
NPI:1710109319
Name:SANCHEZ, JOEL
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12748-0253
Mailing Address - Country:US
Mailing Address - Phone:646-591-7778
Mailing Address - Fax:
Practice Address - Street 1:155 N MAIN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-1864
Practice Address - Country:US
Practice Address - Phone:845-292-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730801981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical