MEDICARE: JOY PARKS

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
1	101YP2500X	Professional Counselor	4395-125	WI

General Provider Information

NPI Number	:	1952614828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY PARKS

Provider Business Mailing Address
First Line	:	9433 W GRANTOSA DR
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53222-1501
Country	:	US
Telephone Number	:	414-943-9559
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 N HOLTON ST
Second Line	:	SUITE 400
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-1064
Country	:	US
Telephone Number	:	414-964-2565
Fax Number	:	414-964-0102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	12/09/2022

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Directions to “ JOY PARKS ” Practice Location

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