Provider Demographics
NPI:1629593892
Name:ANTOINETTE CAVALENES JOYCE
Entity Type:Organization
Organization Name:ANTOINETTE CAVALENES JOYCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVALENES JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-698-3222
Mailing Address - Street 1:14 COLONIAL CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2806
Mailing Address - Country:US
Mailing Address - Phone:718-442-2394
Mailing Address - Fax:
Practice Address - Street 1:290 GARRETSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1236
Practice Address - Country:US
Practice Address - Phone:718-698-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR036109-1261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
254974OtherVALUE OPTIONS
2824155000OtherAMERIHEALTH
7483237OtherGHI
5623681OtherAETNA
NY817451OtherWELLCARE OF NY
053476000OtherMAGELLAN
108633OtherMHN
NYN76411Medicaid
CA6109OtherATLANTIS
N76412OtherEMPIRE BLUE CROSS AND BLUE SHIELD
SEIU135526Other1199SEIU