Provider Demographics
NPI:1790953032
Name:JOYCE, LEQUITA JO (MA,LPC,LMFT)
Entity Type:Individual
Prefix:
First Name:LEQUITA
Middle Name:JO
Last Name:JOYCE
Suffix:
Gender:F
Credentials:MA,LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:100 EAST RAY FINE BLVD. SUITE M.
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954-0378
Mailing Address - Country:US
Mailing Address - Phone:918-427-1311
Mailing Address - Fax:918-427-0013
Practice Address - Street 1:100 EAST RAY FINE BLVD.
Practice Address - Street 2:SUITE M.
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954-0378
Practice Address - Country:US
Practice Address - Phone:918-427-1311
Practice Address - Fax:918-427-0013
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK413101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional