Provider Demographics
NPI:1891155032
Name:JOSEPH, MARC (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2220
Mailing Address - Country:US
Mailing Address - Phone:305-244-9171
Mailing Address - Fax:727-897-8022
Practice Address - Street 1:13899 BISCAYNE BLVD
Practice Address - Street 2:SUITE 223
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33181-1600
Practice Address - Country:US
Practice Address - Phone:305-244-9171
Practice Address - Fax:727-897-8022
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW10364104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker