Provider Demographics
NPI:1770645913
Name:ENGEL, JOEL M (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:M
Last Name:ENGEL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 EASTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4175
Mailing Address - Country:US
Mailing Address - Phone:231-733-9800
Mailing Address - Fax:231-733-1949
Practice Address - Street 1:84 SEAWAY DR
Practice Address - Street 2:BEHAVIORAL HEALTH SERVICES
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444
Practice Address - Country:US
Practice Address - Phone:231-733-9800
Practice Address - Fax:231-733-1949
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010158421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M54220Medicare ID - Type Unspecified