Provider Demographics
NPI:1821229113
Name:OPPENHEIM, JOAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5431
Mailing Address - Country:US
Mailing Address - Phone:203-227-3848
Mailing Address - Fax:203-227-1713
Practice Address - Street 1:1175 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5431
Practice Address - Country:US
Practice Address - Phone:203-227-3848
Practice Address - Fax:203-227-1713
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002458103T00000X
NY015303-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist