Provider Demographics
NPI:1295763506
Name:ANDERSON, JOY HOPKINS (MA, LPC)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:HOPKINS
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15001 WALDEN RD
Mailing Address - Street 2:SUITE 131
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-8578
Mailing Address - Country:US
Mailing Address - Phone:936-539-1251
Mailing Address - Fax:936-582-6366
Practice Address - Street 1:15001 WALDEN RD
Practice Address - Street 2:SUITE 131
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-8578
Practice Address - Country:US
Practice Address - Phone:936-539-1251
Practice Address - Fax:936-582-6366
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12896101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095531201Medicaid