=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184008146
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOY PASCOE COUNSELING P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2015
-----------------------------------------------------
Last Update Date | 07/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 N ISLAND AVE
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60510-1971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-879-3321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 S RIVER ST
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60510-2634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-879-3321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. JOY PASCOE
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 630-879-8321
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 149016803
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------