Provider Demographics
NPI:1447899265
Name:JOSEPH, ANDREW JOHN (EDM, MA, MHC-LP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:EDM, MA, MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 HESTER ST APT 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4776
Mailing Address - Country:US
Mailing Address - Phone:646-242-3646
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY STE 3400
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3054
Practice Address - Country:US
Practice Address - Phone:917-410-0827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP103256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health