Provider Demographics
NPI:1760612204
Name:LEROY, JOSEPH JOHN III (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOHN
Last Name:LEROY
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 MINTERWOOD DRIVE KP N
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-5091
Mailing Address - Country:US
Mailing Address - Phone:253-884-4721
Mailing Address - Fax:253-565-5823
Practice Address - Street 1:6424 N 9TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2091
Practice Address - Country:US
Practice Address - Phone:253-565-4484
Practice Address - Fax:253-565-5823
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker