Provider Demographics
NPI:1578184784
Name:JOYCE, MARY ELIZABETH
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:JOYCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 NE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6415
Mailing Address - Country:US
Mailing Address - Phone:218-325-0517
Mailing Address - Fax:
Practice Address - Street 1:508 COAL AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3913
Practice Address - Country:US
Practice Address - Phone:218-325-0517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2024-10-28
Deactivation Date:2024-10-04
Deactivation Code:
Reactivation Date:2024-10-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health