Healthcare Provider Details

I. General information

NPI: 1891658639
Provider Name (Legal Business Name): A JOY COLLABORATIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1312 2ND AVE UNIT F
CONWAY SC
29526-5215
US

IV. Provider business mailing address

4589 DAY LILY RUN ST
MYRTLE BEACH SC
29579-4679
US

V. Phone/Fax

Practice location:
  • Phone: 843-902-1522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA CAGGIANO
Title or Position: OWNER
Credential: LMSW
Phone: 732-948-5375