Provider Demographics
NPI:1881678571
Name:APPOLLO, JOSEPH PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:APPOLLO
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 1:101 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-7330
Mailing Address - Country:US
Mailing Address - Phone:910-692-2142
Mailing Address - Fax:866-902-8540
Practice Address - Street 1:101 HEATHER LN
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7330
Practice Address - Country:US
Practice Address - Phone:910-692-2142
Practice Address - Fax:866-902-8540
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000041Medicaid
NC6000041Medicaid