Provider Demographics
NPI:1902285588
Name:JOSEPH MICHAEL KANOTZ
Entity Type:Organization
Organization Name:JOSEPH MICHAEL KANOTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RALEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-225-3444
Mailing Address - Street 1:87 E MAIDEN ST
Mailing Address - Street 2:SUITE 31
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4964
Mailing Address - Country:US
Mailing Address - Phone:724-225-3444
Mailing Address - Fax:724-222-2189
Practice Address - Street 1:87 E MAIDEN ST
Practice Address - Street 2:SUITE 31
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4964
Practice Address - Country:US
Practice Address - Phone:724-225-3444
Practice Address - Fax:724-222-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty