Provider Demographics
NPI:1457623571
Name:DEYO, JOANNE EVELYN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:EVELYN
Last Name:DEYO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-6025
Mailing Address - Country:US
Mailing Address - Phone:208-476-7483
Mailing Address - Fax:
Practice Address - Street 1:1275 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544-6025
Practice Address - Country:US
Practice Address - Phone:208-476-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-31240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health