Provider Demographics
NPI:1962641951
Name:EVON, JOYCE A (LPC)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:EVON
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 1:1825 BARNUM AVE
Mailing Address - Street 2:#304
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-5333
Mailing Address - Country:US
Mailing Address - Phone:203-375-5782
Mailing Address - Fax:203-375-3048
Practice Address - Street 1:1825 BARNUM AVE
Practice Address - Street 2:#304
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-5333
Practice Address - Country:US
Practice Address - Phone:203-375-5782
Practice Address - Fax:203-375-3048
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional