Provider Demographics
NPI:1821402785
Name:CLEARY, JOSEPH III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:CLEARY
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 W ROGERS AVE
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY/NEUROPSYCHOLOGY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4545
Mailing Address - Country:US
Mailing Address - Phone:410-578-5114
Mailing Address - Fax:
Practice Address - Street 1:1708 W ROGERS AVE
Practice Address - Street 2:DEPT OF PSYCHOLOGY AND NEUROPSYCHOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4545
Practice Address - Country:US
Practice Address - Phone:410-578-5114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05313103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist