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General NPI Number Information
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NPI Number | 1629224340
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Entity Type | Organization
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Legal Business Name | JOY VALLEY COUNSELING & CONSULTATION P.C.
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 704 PETOSKEY STREET
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-347-0400
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Fax | 231-347-9834
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Provider Business Mailing Address
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Address Line | 704 PETOSKEY STREET
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-347-0400
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Fax | 231-347-9834
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Authorized Official
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Title or Position | DIRECTOR - CLINICAL PSYCHOLOGIST
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Name | MR. TIMOTHY FRANKLIN STRAUSS
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Credential |
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Telephone | 231-347-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801033976
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301005612
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License Number State | MI
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