Provider Demographics
NPI:1467440024
Name:MINTER, JOYCE DAVIS (RN, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:DAVIS
Last Name:MINTER
Suffix:
Gender:F
Credentials:RN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6886 MAIN ST STE 215
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4508
Mailing Address - Country:US
Mailing Address - Phone:678-526-1132
Mailing Address - Fax:678-526-1153
Practice Address - Street 1:6886 MAIN ST STE 215
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4508
Practice Address - Country:US
Practice Address - Phone:678-526-1132
Practice Address - Fax:678-526-1153
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA950263099AMedicaid