Provider Demographics
NPI:1912421702
Name:JAMES K JOSEPH LCSW, LLC
Entity Type:Organization
Organization Name:JAMES K JOSEPH LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KADANKAVIL
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, DSW, MSED
Authorized Official - Phone:267-244-9537
Mailing Address - Street 1:3929 NETHERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1013
Mailing Address - Country:US
Mailing Address - Phone:267-244-9537
Mailing Address - Fax:855-806-5775
Practice Address - Street 1:135 S 19TH ST STE 250
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4906
Practice Address - Country:US
Practice Address - Phone:267-244-5973
Practice Address - Fax:855-806-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW016126261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)