Provider Demographics
NPI:1619198868
Name:WELLS, JOYCE TRULY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:TRULY
Last Name:WELLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130
Mailing Address - Country:US
Mailing Address - Phone:530-251-1281
Mailing Address - Fax:
Practice Address - Street 1:555 HOSPITAL LANE
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130
Practice Address - Country:US
Practice Address - Phone:530-251-8108
Practice Address - Fax:530-251-8394
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS184831041C0700X
NV01688-C1041C0700X
CALCS 18483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical