Provider Demographics
NPI:1124436688
Name:MONROE, JOEL MICHAEL (PSYD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:MICHAEL
Last Name:MONROE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843425
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3425
Mailing Address - Country:US
Mailing Address - Phone:910-715-3376
Mailing Address - Fax:910-715-5391
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-3376
Practice Address - Fax:910-715-5391
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist