Provider Demographics
NPI:1578190435
Name:THAYER, JOEL (LMHC, MFA, JD, CP)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:THAYER
Suffix:
Gender:M
Credentials:LMHC, MFA, JD, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-2206
Mailing Address - Country:US
Mailing Address - Phone:774-218-0303
Mailing Address - Fax:
Practice Address - Street 1:79 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2206
Practice Address - Country:US
Practice Address - Phone:774-203-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10000917101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health