Healthcare Provider Details

I. General information

NPI: 1285222349
Provider Name (Legal Business Name): JOY LEAH SCHIAVONE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 EMMET ST N
CHARLOTTESVILLE VA
22901-2812
US

IV. Provider business mailing address

PO BOX 99
GOOCHLAND VA
23063-0099
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-7198
  • Fax:
Mailing address:
  • Phone: 804-457-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701009441
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: