Healthcare Provider Details

I. General information

NPI: 1124533153
Provider Name (Legal Business Name): JOY E DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 HARPER DR NE STE 210
ALBUQUERQUE NM
87109-3541
US

IV. Provider business mailing address

2809 ALVARADO DR NE
ALBUQUERQUE NM
87110-3229
US

V. Phone/Fax

Practice location:
  • Phone: 505-451-4049
  • Fax:
Mailing address:
  • Phone: 505-208-2214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: