Provider Demographics
NPI:1831283365
Name:CARVER, JOSEPH MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:CARVER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 6TH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4158
Mailing Address - Country:US
Mailing Address - Phone:740-353-1548
Mailing Address - Fax:740-353-7198
Practice Address - Street 1:806 6TH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4158
Practice Address - Country:US
Practice Address - Phone:740-353-1548
Practice Address - Fax:740-353-7198
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4333103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0812204Medicaid
OH4333OtherOHIO PSYCHOLOGIST LICENSE
OH4333OtherOHIO PSYCHOLOGIST LICENSE