Provider Demographics
NPI:1295370781
Name:ELIZABETH JOY LLC
Entity Type:Organization
Organization Name:ELIZABETH JOY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:614-332-1592
Mailing Address - Street 1:PO BOX 360661
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43236-0661
Mailing Address - Country:US
Mailing Address - Phone:614-332-1592
Mailing Address - Fax:
Practice Address - Street 1:261 W JOHNSTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2887
Practice Address - Country:US
Practice Address - Phone:614-332-1592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0315391Medicaid