Individual
JOEL TYLER WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10756 W BUCHANAN ST, AVONDALE, AZ 85323-5441
(360) 703-7138
Mailing address
10756 W BUCHANAN ST, AVONDALE, AZ 85323-5441
(360) 703-7138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
22756
AZ
101YP2500X
Professional Counselor
Primary
LPC-22756
AZ
Other
Enumeration date
12/25/2023
Last updated
02/21/2024
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