Provider Demographics
NPI:1457978322
Name:PATRICK MARCOUX
Entity Type:Organization
Organization Name:PATRICK MARCOUX
Other - Org Name:THE JOYFUL THERAPIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARCOUX
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-543-4221
Mailing Address - Street 1:39 S MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1590
Mailing Address - Country:US
Mailing Address - Phone:215-543-4221
Mailing Address - Fax:844-538-1691
Practice Address - Street 1:39 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1590
Practice Address - Country:US
Practice Address - Phone:269-830-3791
Practice Address - Fax:844-538-1691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE JOYFUL THERAPIST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-26
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1457978322Medicaid
MI1144761172Medicaid