Provider Demographics
NPI:1124426879
Name:JOSEPH, ALYSSE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:ALYSSE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 SAVAGE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4620
Mailing Address - Country:US
Mailing Address - Phone:301-615-0784
Mailing Address - Fax:
Practice Address - Street 1:474 BONNETT ST APT B
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-3350
Practice Address - Country:US
Practice Address - Phone:301-615-0784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD203351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty