Provider Demographics
NPI:1902814809
Name:JOSLYN, THOMAS R (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:R
Last Name:JOSLYN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PINE ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-1906
Mailing Address - Country:US
Mailing Address - Phone:315-768-9217
Mailing Address - Fax:
Practice Address - Street 1:10 PINE ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1906
Practice Address - Country:US
Practice Address - Phone:315-768-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical