Provider Demographics
NPI:1629371547
Name:JOYCE, THOMAS (LCDP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:JOYCE
Suffix:
Gender:M
Credentials:LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BAKER PINE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:RI
Mailing Address - Zip Code:02898-1000
Mailing Address - Country:US
Mailing Address - Phone:401-539-3002
Mailing Address - Fax:401-722-5039
Practice Address - Street 1:15 BAKER PINE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:RI
Practice Address - Zip Code:02898-1000
Practice Address - Country:US
Practice Address - Phone:401-539-3002
Practice Address - Fax:401-722-5039
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP00465101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid