Provider Demographics
NPI:1215075981
Name:JOSEPH, NORMA L (LISW LICDC)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:L
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LISW LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25571 EDGECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132
Mailing Address - Country:US
Mailing Address - Phone:216-261-6776
Mailing Address - Fax:
Practice Address - Street 1:LAKELAND MEDICAL BLVD #107
Practice Address - Street 2:2570 LAKLAND BLVD
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132
Practice Address - Country:US
Practice Address - Phone:216-261-6776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 51381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005225671OtherAETNA
000000298860OtherANTHEM BS BC
224380OtherVALUE OPTIONS
71190OtherQUAL CHOICE