Provider Demographics
NPI:1003934027
Name:BEVONI, JOY LOUISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:LOUISE
Last Name:BEVONI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13628 GENA DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75709-5722
Mailing Address - Country:US
Mailing Address - Phone:903-520-3533
Mailing Address - Fax:
Practice Address - Street 1:14023 STATE HIGHWAY 155 S
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6635
Practice Address - Country:US
Practice Address - Phone:903-534-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health