Healthcare Provider Details

I. General information

NPI: 1700708161
Provider Name (Legal Business Name): TYSHAYLA C JOYNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BRIGHTLEAF BLVD STE 4
SMITHFIELD NC
27577-4077
US

IV. Provider business mailing address

227 BRICK KILN LOOP
CLAYTON NC
27520-9691
US

V. Phone/Fax

Practice location:
  • Phone: 919-626-8343
  • Fax: 877-568-6255
Mailing address:
  • Phone: 919-741-2622
  • Fax: 877-568-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23229
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: