Provider Demographics
NPI:1629224340
Name:JOY VALLEY COUNSELING & CONSULTATION P.C.
Entity Type:Organization
Organization Name:JOY VALLEY COUNSELING & CONSULTATION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-347-0400
Mailing Address - Street 1:704 PETOSKEY STREET
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770
Mailing Address - Country:US
Mailing Address - Phone:231-347-0400
Mailing Address - Fax:231-347-9834
Practice Address - Street 1:704 PETOSKEY STREET
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770
Practice Address - Country:US
Practice Address - Phone:231-347-0400
Practice Address - Fax:231-347-9834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOY VALLEY COUNSELING AND CONSULTATION, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005612103T00000X
MI6801033976104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty