Provider Demographics
NPI:1134106891
Name:FROST, JOEL CHRISTOPHER (EDD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:CHRISTOPHER
Last Name:FROST
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 AMORY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3520
Mailing Address - Country:US
Mailing Address - Phone:617-734-5414
Mailing Address - Fax:
Practice Address - Street 1:877 BEACON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3801
Practice Address - Country:US
Practice Address - Phone:617-266-1616
Practice Address - Fax:617-266-1616
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3612103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling