Provider Demographics
NPI:1447611199
Name:HATEM-ROY, JOAN (LICSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:HATEM-ROY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MERRIMACK STREET
Mailing Address - Street 2:ELDER SERVICES OF THE MERRIMACK VALLEY
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01830
Mailing Address - Country:US
Mailing Address - Phone:978-946-1361
Mailing Address - Fax:
Practice Address - Street 1:280 MERRIMACK STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-946-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10179681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical