Provider Demographics
NPI:1699868513
Name:JOSEPH, JENNIFER ELIZABETH (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11929 SAND DOLLAR CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9683
Mailing Address - Country:US
Mailing Address - Phone:317-518-0796
Mailing Address - Fax:844-774-0513
Practice Address - Street 1:52 S 9TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2601
Practice Address - Country:US
Practice Address - Phone:317-498-7926
Practice Address - Fax:844-774-0513
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005621A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000594137OtherANTHEM BLUE CROSS BLUE SHIELD
IN000000594137OtherANTHEM BLUE CROSS BLUE SHIELD