Provider Demographics
NPI:1821250309
Name:DR. JOSEPH M. WOLSTENCROFT PHD LPC INC.
Entity Type:Organization
Organization Name:DR. JOSEPH M. WOLSTENCROFT PHD LPC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:M
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-746-5800
Mailing Address - Street 1:2484 INGLESIDE AVE STE C103
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-6520
Mailing Address - Country:US
Mailing Address - Phone:478-746-5800
Mailing Address - Fax:
Practice Address - Street 1:2484 INGLESIDE AVE STE C103
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-6520
Practice Address - Country:US
Practice Address - Phone:478-746-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1545101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty