Provider Demographics
NPI:1568173037
Name:DR. STACY PIPES-JOYNER, LICENSED CLINICAL SOCIAL WORKER INC.
Entity Type:Organization
Organization Name:DR. STACY PIPES-JOYNER, LICENSED CLINICAL SOCIAL WORKER INC.
Other - Org Name:ENDEAVOR YOUTH & FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPES-JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW
Authorized Official - Phone:951-420-4651
Mailing Address - Street 1:6809 INDIANA AVE # 130-B11
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4221
Mailing Address - Country:US
Mailing Address - Phone:951-420-4651
Mailing Address - Fax:
Practice Address - Street 1:13831 NATHAN PL
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-5609
Practice Address - Country:US
Practice Address - Phone:951-420-4651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health