MEDICARE: MURIELLE EDEN 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
1	101YM0800X	Mental Health Counselor	068.0137195TELE	VT
2	101YM0800X	Mental Health Counselor	MH26303	FL
3	101YM0800X	Mental Health Counselor	9781504	ID

General Provider Information

NPI Number	:	1689407918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MURIELLE EDEN JOSEPH

Provider Business Mailing Address
First Line	:	255 NW 116TH AVE APT 304
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-6099
Country	:	US
Telephone Number	:	954-774-0195
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 NW 116TH AVE APT 304
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-6099
Country	:	US
Telephone Number	:	954-774-0195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	05/27/2026

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Directions to “ MURIELLE EDEN JOSEPH ” Practice Location

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