Provider Demographics
NPI:1265975882
Name:JOSEPH, STEPHANIE (MASTERS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 READ BLVD
Mailing Address - Street 2:SUITE 740
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LOUISIANA
Mailing Address - Zip Code:70127
Mailing Address - Country:UM
Mailing Address - Phone:504-245-2440
Mailing Address - Fax:504-245-4284
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:SUITE 740
Practice Address - City:NEW ORLEANS
Practice Address - State:LOUISIANA
Practice Address - Zip Code:70127
Practice Address - Country:UM
Practice Address - Phone:504-245-2440
Practice Address - Fax:504-245-4284
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X171M00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator