Basic Information
| Provider Information | |||||||||
| NPI: | 1619335791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHOROKEY | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPCC- S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 BELMONT AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445021039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307932487 | ||||||||
| FaxNumber: | 3307435748 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 BELMONT AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445021039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307932487 | ||||||||
| FaxNumber: | 3307435748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2016 | ||||||||
| LastUpdateDate: | 02/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E0001704-SUPV | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.