Provider Demographics
NPI:1255560348
Name:EILYTHIA, JOY (PHD, LPC)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:EILYTHIA
Suffix:
Gender:F
Credentials:PHD, LPC
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 1662
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1662
Mailing Address - Country:US
Mailing Address - Phone:458-221-9848
Mailing Address - Fax:
Practice Address - Street 1:19820 VILLAGE OFFICE CT
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2947
Practice Address - Country:US
Practice Address - Phone:458-221-9848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health