Provider Demographics
NPI:1043453590
Name:DELISLE, JOY E (LPCC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:E
Last Name:DELISLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11433 HOPE MEANS RD
Mailing Address - Street 2:
Mailing Address - City:MEANS
Mailing Address - State:KY
Mailing Address - Zip Code:40346-7808
Mailing Address - Country:US
Mailing Address - Phone:304-813-4814
Mailing Address - Fax:859-498-2606
Practice Address - Street 1:700 HOPE HILL RD
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:KY
Practice Address - Zip Code:40334-7002
Practice Address - Country:US
Practice Address - Phone:859-498-5230
Practice Address - Fax:859-498-2606
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY166347101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD035349300Medicaid