Provider Demographics
NPI:1952096497
Name:JOE, NJIE
Entity Type:Individual
Prefix:
First Name:NJIE
Middle Name:
Last Name:JOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 CONCORDE CIR UNIT 33217
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1796
Mailing Address - Country:US
Mailing Address - Phone:202-747-8098
Mailing Address - Fax:
Practice Address - Street 1:830 CONCORDE CIR UNIT 33217
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-1796
Practice Address - Country:US
Practice Address - Phone:202-747-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health