Provider Demographics
NPI:1033298799
Name:HEADY, JOYCE MARIE (LCSW, LMSW,CASAC)
Entity Type:Individual
Prefix:MISS
First Name:JOYCE
Middle Name:MARIE
Last Name:HEADY
Suffix:
Gender:F
Credentials:LCSW, LMSW,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 NORTH ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5660
Mailing Address - Country:US
Mailing Address - Phone:203-778-3838
Mailing Address - Fax:
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 419
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5660
Practice Address - Country:US
Practice Address - Phone:203-778-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0052651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT201166873OtherFSC TAX ID#