Provider Demographics
NPI:1073821583
Name:JOYCE, KELLIE JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLIE
Middle Name:JEAN
Last Name:JOYCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSAD6 100 MAIN STREET P.O.BOX 38
Mailing Address - Street 2:
Mailing Address - City:BAR MILLS
Mailing Address - State:ME
Mailing Address - Zip Code:04004
Mailing Address - Country:US
Mailing Address - Phone:207-929-3831
Mailing Address - Fax:
Practice Address - Street 1:912 LONG PLAINS RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-3208
Practice Address - Country:US
Practice Address - Phone:207-929-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC41671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical