Provider Demographics
NPI:1093932188
Name:WICKHAM, JOYCE MURPHY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:MURPHY
Last Name:WICKHAM
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 1:205 CHAD PL
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19970-9787
Mailing Address - Country:US
Mailing Address - Phone:302-541-4887
Mailing Address - Fax:
Practice Address - Street 1:205 CHAD PL
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19970-9787
Practice Address - Country:US
Practice Address - Phone:302-541-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100007661041C0700X
DEQ1-00007661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE491986Medicare ID - Type Unspecified