Provider Demographics
NPI:1851478499
Name:WAIBEL, JOSEPH H (MA LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:H
Last Name:WAIBEL
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S MAIN ST
Mailing Address - Street 2:SUITE 150 #12
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-7043
Mailing Address - Country:US
Mailing Address - Phone:817-454-0011
Mailing Address - Fax:
Practice Address - Street 1:750 S MAIN ST
Practice Address - Street 2:SUITE 150 #12
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-7043
Practice Address - Country:US
Practice Address - Phone:817-454-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156964204Medicaid
TX2201102OtherFIRSTHEALTH PIN
TX810578612OtherPHCS PIN
TX83943LOtherBCBSTX IND PIN
TX00G981OtherBCBSTX GRP PIN
TX10011447OtherAMERIGROUP PIN
TX124066OtherSUPERIOR PIN
TX156964203Medicaid
TX75205164618OtherPBH PIN