Provider Demographics
NPI:1184957664
Name:GREENBERG, JOEL PETER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:PETER
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WESTOWN PKWY STE 425
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1434
Mailing Address - Country:US
Mailing Address - Phone:515-259-0706
Mailing Address - Fax:
Practice Address - Street 1:2700 WESTOWN PKWY STE 425
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1434
Practice Address - Country:US
Practice Address - Phone:515-259-0706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24861103TC0700X
IA099628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical