Healthcare Provider Details

I. General information

NPI: 1316873193
Provider Name (Legal Business Name): JOY IDOKO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CUMMINGS PARK STE 200
WOBURN MA
01801-2198
US

IV. Provider business mailing address

130 ESSEX ST # 175
SOUTH HAMILTON MA
01982-2325
US

V. Phone/Fax

Practice location:
  • Phone: 781-305-4086
  • Fax: 781-305-4087
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10005939
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: