Provider Demographics
NPI:1760508162
Name:DE PELICHY, JOY R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:R
Last Name:DE PELICHY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CAMINO EL ALTO NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-9570
Mailing Address - Country:US
Mailing Address - Phone:505-292-4859
Mailing Address - Fax:505-293-7045
Practice Address - Street 1:615 ORTIZ DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1446
Practice Address - Country:US
Practice Address - Phone:505-266-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health