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NPI Code Detail

MEDICARE: JOY STUCKER LCMHCA

MEDICARE: JOY STUCKER LCMHCA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194508069
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY STUCKER LCMHCA
Provider Business Mailing Address
First Line : PO BOX 620701
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-0111
Country : US
Telephone Number : 704-533-5810
Fax Number : 980-598-8019
Provider Business Practice Location Address
First Line : 6419 BANNINGTON RD STE B
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-1341
Country : US
Telephone Number : 704-533-5810
Fax Number : 980-598-8019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2023
Last Update Date : 08/15/2023

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