Healthcare Provider Details

I. General information

NPI: 1396649174
Provider Name (Legal Business Name): JOSEPH CARPENTIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 COMMERCE PARK DR STE 110
WILLIAMSPORT PA
17701-5475
US

IV. Provider business mailing address

1000 COMMERCE PARK DR STE 110
WILLIAMSPORT PA
17701-5475
US

V. Phone/Fax

Practice location:
  • Phone: 877-907-7970
  • Fax:
Mailing address:
  • Phone: 877-907-7970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: