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NPI Code Detail

MEDICARE: ANDJY JOSEPH

MEDICARE: ANDJY JOSEPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCSW007558GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1880077446OTHERGALEGAL ZOOM

General Provider Information

NPI Number : 1124475538
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDJY JOSEPH
Provider Business Mailing Address
First Line : 650 PONCE DE LEON AVE NE STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30308-1864
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 PONCE DE LEON AVE NE STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30308-1864
Country : US
Telephone Number : 404-563-5228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2016
Last Update Date : 02/08/2023

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