=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215269717
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOYCE JAMES L.C.S.W - R; BCD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2010
-----------------------------------------------------
Last Update Date | 02/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21910 S CONDUIT AVE
-----------------------------------------------------
City | SPRINGFIELD GARDENS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11413-3462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-847-0976
-----------------------------------------------------
Fax | 718-847-0976
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 751208
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-8808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-847-0976
-----------------------------------------------------
Fax | 718-847-0976
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0249691
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------