Provider Demographics
NPI:1285106807
Name:PAUL, JOEY D (MA, LCPC)
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:D
Last Name:PAUL
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 N MILWAUKEE AVE APT 221
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1789
Mailing Address - Country:US
Mailing Address - Phone:847-903-3580
Mailing Address - Fax:
Practice Address - Street 1:1980 N MILWAUKEE AVE APT 421
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1789
Practice Address - Country:US
Practice Address - Phone:847-903-3580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional