Healthcare Provider Details

I. General information

NPI: 1609948074
Provider Name (Legal Business Name): JOEL JAMES LORD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GOLDEN HILL LN
KINGSTON NY
12401-6441
US

IV. Provider business mailing address

211 WINDSOR DR
HURLEY NY
12443-5328
US

V. Phone/Fax

Practice location:
  • Phone: 845-340-4000
  • Fax: 845-340-4094
Mailing address:
  • Phone: 845-339-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number012972
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number012972
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number012972
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: