Provider Demographics
NPI:1073148177
Name:JOY, PAIGE SUSAN I (SUD COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:SUSAN
Last Name:JOY
Suffix:I
Gender:F
Credentials:SUD COUNSELOR
Other - Prefix:MS
Other - First Name:PAIGE
Other - Middle Name:SUSAN
Other - Last Name:JOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUD COUNSELOR
Mailing Address - Street 1:470 E 3RD ST STE C
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1630
Mailing Address - Country:US
Mailing Address - Phone:213-620-5712
Mailing Address - Fax:
Practice Address - Street 1:470 E 3RD ST STE C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1630
Practice Address - Country:US
Practice Address - Phone:213-620-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA019260615101YA0400X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)