Provider Demographics
NPI:1720007339
Name:BRANCH, JOSEPH A (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:BRANCH
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 1:800 S CHURCH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4154
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-933-9395
Practice Address - Street 1:800 S CHURCH ST STE 103
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4154
Practice Address - Country:US
Practice Address - Phone:870-277-4357
Practice Address - Fax:870-292-3603
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0506039101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y582OtherBLUECROSS PROVIDER NUMBER
AR5Y582OtherBCBS
AR174488795Medicaid