Provider Demographics
NPI:1417013962
Name:MIERZEJWSKI, JOYCE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:MIERZEJWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 MAIN ST
Mailing Address - Street 2:APT. C
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3420
Mailing Address - Country:US
Mailing Address - Phone:973-751-4207
Mailing Address - Fax:973-857-5333
Practice Address - Street 1:155 POMPTON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2942
Practice Address - Country:US
Practice Address - Phone:973-857-5333
Practice Address - Fax:973-857-5338
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC0515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0515OtherLICENSE