Healthcare Provider Details

I. General information

NPI: 1285647974
Provider Name (Legal Business Name): JOHN J JOYCE III LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 SOUTH MAIN ST 3RD FLOOR
WEST HARTFORD CT
06107-3452
US

IV. Provider business mailing address

170 SOUTH MAIN ST
WEST HARTFORD CT
06107-3452
US

V. Phone/Fax

Practice location:
  • Phone: 860-539-4599
  • Fax: 860-561-2815
Mailing address:
  • Phone: 860-521-3929
  • Fax: 860-561-2815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number001901
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: