Provider Demographics
NPI:1215989728
Name:EISENBERG, JOSEPH MARTIN (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARTIN
Last Name:EISENBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 YORK RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6024
Mailing Address - Country:US
Mailing Address - Phone:410-321-9101
Mailing Address - Fax:410-823-6204
Practice Address - Street 1:1402 YORK RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6024
Practice Address - Country:US
Practice Address - Phone:410-321-9101
Practice Address - Fax:410-823-6204
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00988103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling