=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114821519
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOYUS THERAPY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2026
-----------------------------------------------------
Last Update Date | 10/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26601 STONEY PASS RD
-----------------------------------------------------
City | SEDALIA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80135-9003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-622-5753
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26601 STONEY PASS RD
-----------------------------------------------------
City | SEDALIA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80135-9003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-622-5753
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALEC WARREN HERBERHOLZ
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 916-622-5753
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------