Provider Demographics
NPI:1619578549
Name:JOY LOVE TELEHEALTH
Entity Type:Organization
Organization Name:JOY LOVE TELEHEALTH
Other - Org Name:JOY LOVE
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-716-5797
Mailing Address - Street 1:510 HIGHLAND AVE # 245
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1516
Mailing Address - Country:US
Mailing Address - Phone:248-716-5797
Mailing Address - Fax:
Practice Address - Street 1:15700 W 10 MILE RD STE 106
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-716-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty