Healthcare Provider Details

I. General information

NPI: 1225540891
Provider Name (Legal Business Name): JOYCE ELIZABETH CHESTNUT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYCE ELIZABETH CHESTNUT

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 TAPLOW TRL
CAMERON NC
28326-7988
US

IV. Provider business mailing address

19 TAPLOW TRL
CAMERON NC
28326-7988
US

V. Phone/Fax

Practice location:
  • Phone: 910-751-9959
  • Fax:
Mailing address:
  • Phone: 910-751-9959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number11404
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number819
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number11404
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: