Provider Demographics
NPI:1366681132
Name:MCPHILLIPS, JOYCE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:MCPHILLIPS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-0150
Mailing Address - Country:US
Mailing Address - Phone:631-858-3505
Mailing Address - Fax:
Practice Address - Street 1:700 VANDERBILT PKWY
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-0150
Practice Address - Country:US
Practice Address - Phone:631-858-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012213-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist