Healthcare Provider Details

I. General information

NPI: 1245576537
Provider Name (Legal Business Name): JOYCE MORGAN ELIAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 BOSTON POST RD
WATERFORD CT
06385-2423
US

IV. Provider business mailing address

PO BOX 113
NORTH STONINGTON CT
06359-0113
US

V. Phone/Fax

Practice location:
  • Phone: 860-245-9113
  • Fax: 860-245-9113
Mailing address:
  • Phone: 860-245-9113
  • Fax: 860-599-5804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00560
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002293
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: