Provider Demographics
NPI:1508408337
Name:JOY, MATTHEW ALAN
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALAN
Last Name:JOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1803
Mailing Address - Country:US
Mailing Address - Phone:740-371-5476
Mailing Address - Fax:740-371-5482
Practice Address - Street 1:812 3RD ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1803
Practice Address - Country:US
Practice Address - Phone:740-371-5476
Practice Address - Fax:740-371-5482
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171751101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)