Healthcare Provider Details

I. General information

NPI: 1083226518
Provider Name (Legal Business Name): JOYFUL ADVANTAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 COLUMBIA ST
NORTH CHELMSFORD MA
01863-1901
US

IV. Provider business mailing address

PO BOX 285
STOUGHTON MA
02072-0285
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-5774
  • Fax:
Mailing address:
  • Phone: 508-287-9426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ARIEL JOY SHAPIRO
Title or Position: CEO
Credential: LMHC
Phone: 617-855-5774