Healthcare Provider Details

I. General information

NPI: 1255729307
Provider Name (Legal Business Name): JOYCE VICTOR M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOYCE VICTOR MSW

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N GUADALUPE ST # 458
SANTA FE NM
87501-1868
US

IV. Provider business mailing address

1127 10TH AVE E STE 6
SEATTLE WA
98102-4377
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-7969
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLW00005833
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: