Provider Demographics
NPI:1083819494
Name:WOLPERT, JOYCE BARBARA (LCPC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:BARBARA
Last Name:WOLPERT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 CLARKS LN
Mailing Address - Street 2:APT. A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2755
Mailing Address - Country:US
Mailing Address - Phone:410-358-0977
Mailing Address - Fax:
Practice Address - Street 1:3601 CLARKS LN
Practice Address - Street 2:2A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2731
Practice Address - Country:US
Practice Address - Phone:410-358-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0062101YM0800X, 225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD286AOtherCAREFIRST
MD7700429OtherAETNA
DCJ3290001OtherCAREFIRST
MD7700429OtherAETNA