Provider Demographics
NPI:1881910594
Name:OPPENHEIMER, JOEL (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:OPPENHEIMER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 KENT ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2175
Mailing Address - Country:US
Mailing Address - Phone:415-336-6695
Mailing Address - Fax:
Practice Address - Street 1:197 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5507
Practice Address - Country:US
Practice Address - Phone:646-395-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078017104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker