Healthcare Provider Details

I. General information

NPI: 1598286122
Provider Name (Legal Business Name): JOYCE E NEWCOMB, PHD, RN, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4627 NW 58TH AVE
CORAL SPRINGS FL
33067-2193
US

IV. Provider business mailing address

4627 NW 58TH AVE
CORAL SPRINGS FL
33067-2193
US

V. Phone/Fax

Practice location:
  • Phone: 954-501-4677
  • Fax: 954-757-0911
Mailing address:
  • Phone: 954-501-4677
  • Fax: 954-757-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3619
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT877
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN953092
License Number StateFL

VIII. Authorized Official

Name: JOYCE ELIZABETH NEWCOMB
Title or Position: PRES/SEC
Credential: LMHC
Phone: 954-501-4677