Provider Demographics
NPI:1083893861
Name:BROSS, JOYCE (LSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:BROSS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:BROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:31 RIDGEWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825
Mailing Address - Country:US
Mailing Address - Phone:908-454-5141
Mailing Address - Fax:
Practice Address - Street 1:492 ROUTE 57 WEST
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN CO
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1420
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05051900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker