Provider Demographics
NPI:1972843407
Name:SMULLEN, JOSEPH PATRICK (LCSW-S)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PATRICK
Last Name:SMULLEN
Suffix:
Gender:M
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604E POLK AVE
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-2604
Mailing Address - Country:US
Mailing Address - Phone:361-237-0729
Mailing Address - Fax:
Practice Address - Street 1:5606 N NAVARRO ST STE 302A
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1770
Practice Address - Country:US
Practice Address - Phone:361-210-6898
Practice Address - Fax:832-324-7856
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5748131041C0700X
TX57483104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical