Provider Demographics
NPI:1982661732
Name:LEET-MULLINS, JOY D (MS, LCSW, DCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:D
Last Name:LEET-MULLINS
Suffix:
Gender:F
Credentials:MS, LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 COPPER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1299
Mailing Address - Country:US
Mailing Address - Phone:859-224-4062
Mailing Address - Fax:859-276-0707
Practice Address - Street 1:1910 GARDEN SPRINGS DR
Practice Address - Street 2:STE 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3629
Practice Address - Country:US
Practice Address - Phone:859-224-4062
Practice Address - Fax:859-276-0707
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCSW0297Medicare PIN