Provider Demographics
NPI:1922412824
Name:JOEL J. EPSTEIN, PHD
Entity Type:Organization
Organization Name:JOEL J. EPSTEIN, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-796-4623
Mailing Address - Street 1:587 S DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-6256
Mailing Address - Country:US
Mailing Address - Phone:727-796-4623
Mailing Address - Fax:727-466-0818
Practice Address - Street 1:587 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6256
Practice Address - Country:US
Practice Address - Phone:727-796-4623
Practice Address - Fax:727-466-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3549103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75586Medicare PIN