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NPI Code Detail

MEDICARE: JOYCE GANAPOL LICSW

MEDICARE: JOYCE GANAPOL LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker113498MA

General Provider Information

NPI Number : 1043449283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCE GANAPOL LICSW
Provider Business Mailing Address
First Line : 111 EDGARTOWN VINEYARD HAVEN RD
Second Line : MARTHA'S VINEYARD COMMUNITY SERVICES
City : VINEYARD HAVEN
State : MA
Zip : 02568-4036
Country : US
Telephone Number : 508-693-7900
Fax Number : 508-696-0401
Provider Business Practice Location Address
First Line : 111 EDGARTOWN VINEYARD HAVEN RD
Second Line : MARTHA'S VINEYARD COMMUNITY SERVICES
City : VINEYARD HAVEN
State : MA
Zip : 02568-4036
Country : US
Telephone Number : 508-693-7900
Fax Number : 508-696-0401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2009
Last Update Date : 07/09/2009

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