Provider Demographics
NPI:1679796908
Name:WARREN, JOSEPH WILBURN III (LPC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:WILBURN
Last Name:WARREN
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6929 CAMP BULLIS RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2334
Mailing Address - Country:US
Mailing Address - Phone:210-698-4629
Mailing Address - Fax:
Practice Address - Street 1:6929 CAMP BULLIS RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2334
Practice Address - Country:US
Practice Address - Phone:210-698-4629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional