Provider Demographics
NPI:1881406452
Name:EBBINGER, JOSEPH (LPC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:EBBINGER
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MENKAR AVE
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2409
Mailing Address - Country:US
Mailing Address - Phone:856-761-7901
Mailing Address - Fax:
Practice Address - Street 1:3535 MARKET ST STE 500
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3344
Practice Address - Country:US
Practice Address - Phone:215-746-6701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health