Provider Demographics
NPI:1962782763
Name:WEXLER, JOAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:WEXLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 BRADLEY ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1105
Mailing Address - Country:US
Mailing Address - Phone:203-624-9381
Mailing Address - Fax:
Practice Address - Street 1:255 BRADLEY ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1105
Practice Address - Country:US
Practice Address - Phone:203-624-9381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000067104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker