Provider Demographics
NPI:1942026570
Name:PHILLIPS, JOSEPH PAUL (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 PEONY LN
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4668
Mailing Address - Country:US
Mailing Address - Phone:779-803-4031
Mailing Address - Fax:
Practice Address - Street 1:960 PEONY LN
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4668
Practice Address - Country:US
Practice Address - Phone:779-803-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical