Provider Demographics
NPI:1033268099
Name:ROY, JOANNE T (LCSW LADC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:T
Last Name:ROY
Suffix:
Gender:F
Credentials:LCSW LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2720
Mailing Address - Country:US
Mailing Address - Phone:207-283-0323
Mailing Address - Fax:
Practice Address - Street 1:250 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2545
Practice Address - Country:US
Practice Address - Phone:207-775-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME319441101YA0400X
MEME313632101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health