Provider Demographics
NPI:1386737153
Name:KORZELIUS, JOSEPH FRANK (LPC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANK
Last Name:KORZELIUS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 GRADY AVE
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3064
Mailing Address - Country:US
Mailing Address - Phone:864-775-8307
Mailing Address - Fax:
Practice Address - Street 1:68 POINTE CIR STE 3201
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6307
Practice Address - Country:US
Practice Address - Phone:864-952-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11590495OtherCAQH #