Provider Demographics
NPI:1336602333
Name:JOSEPH, JOYY JERMAINE (MA)
Entity Type:Individual
Prefix:
First Name:JOYY
Middle Name:JERMAINE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 LORETTA ST
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346-4167
Mailing Address - Country:US
Mailing Address - Phone:225-717-2582
Mailing Address - Fax:
Practice Address - Street 1:252 HECTOR AVE STE A
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2548
Practice Address - Country:US
Practice Address - Phone:504-502-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA822459201Medicaid