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General NPI Number Information
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NPI Number | 1144946906
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Entity Type | Individual
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Provider Name | JUSTIN JOSEPH LMSW
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Gender | Male
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 5305 LAUREL BRANCH DR.
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City | DALLAS
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State | TX
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Zip | 75209
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Country | US
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Telephone | 972-514-2992
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 E ROSEMEADE PKWY # 5015
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City | CARROLLTON
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State | TX
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Zip | 75007-2637
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Country | US
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Telephone | 214-444-3196
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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