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General NPI Number Information
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NPI Number | 1780032078
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Entity Type | Organization
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Legal Business Name | JOYCE M. HEADY, LLC
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 100 MILL PLAIN RD 3RD FLOOR
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City | DANBURY
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State | CT
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Zip | 06811-5178
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Country | US
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Telephone | 860-982-8950
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Fax | 866-212-4376
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Provider Business Mailing Address
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Address Line | 473 N SALEM RD
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City | BREWSTER
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State | NY
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Zip | 10509-3517
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Country | US
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Telephone | 860-982-8950
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Fax | 866-212-4376
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Authorized Official
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Title or Position | OWNER
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Name | JOYCE M HEADY
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Credential | LCSW
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Telephone | 860-992-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 005265
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License Number State | CT
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