Provider Demographics
NPI:1548374457
Name:YURMAN, JOANNE S (PHD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:S
Last Name:YURMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682
Mailing Address - Street 2:31 MAIN STREET
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0682
Mailing Address - Country:US
Mailing Address - Phone:413-298-7146
Mailing Address - Fax:413-232-4647
Practice Address - Street 1:31 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262-0682
Practice Address - Country:US
Practice Address - Phone:413-298-7146
Practice Address - Fax:413-232-4647
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6251103TC0700X
NY010115-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO4993Medicare ID - Type Unspecified
NYV95441Medicare ID - Type Unspecified