Provider Demographics
NPI:1558506766
Name:BOCANEGRA, JOYCE M (LCPC)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:BOCANEGRA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15127 S 73RD AVE STE G
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3425
Mailing Address - Country:US
Mailing Address - Phone:708-845-5500
Mailing Address - Fax:708-845-5505
Practice Address - Street 1:15127 S 73RD AVE STE G
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3425
Practice Address - Country:US
Practice Address - Phone:708-845-5500
Practice Address - Fax:708-845-5505
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178005795101YP2500X
IL180.007863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional