Provider Demographics
NPI:1205066487
Name:YASKIN, JOSEPH CHARLES (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHARLES
Last Name:YASKIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:YASKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:148 STONEWAY LN
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3125
Mailing Address - Country:US
Mailing Address - Phone:610-450-6763
Mailing Address - Fax:866-446-1126
Practice Address - Street 1:4 E GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1533
Practice Address - Country:US
Practice Address - Phone:484-278-1755
Practice Address - Fax:844-673-2239
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0169991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102273449Medicaid