Provider Demographics
NPI:1295876654
Name:GREWE, JOYCE LORRAINE (LMHC LPC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:LORRAINE
Last Name:GREWE
Suffix:
Gender:F
Credentials:LMHC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 POLK AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CANAVERAL
Mailing Address - State:FL
Mailing Address - Zip Code:32920
Mailing Address - Country:US
Mailing Address - Phone:321-784-1845
Mailing Address - Fax:
Practice Address - Street 1:280 E MERRITT AVE
Practice Address - Street 2:SPIRITUAL CARE & COUNSELING CENTER
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953
Practice Address - Country:US
Practice Address - Phone:321-784-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4020101YM0800X
MI106401000664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional