Provider Demographics
NPI:1093470387
Name:GENDLER, JOYCE (LPC, REAT, NCC)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:GENDLER
Suffix:
Gender:F
Credentials:LPC, REAT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 MUNGERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1935
Mailing Address - Country:US
Mailing Address - Phone:240-731-8968
Mailing Address - Fax:
Practice Address - Street 1:10 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3033
Practice Address - Country:US
Practice Address - Phone:203-245-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional