Provider Demographics
NPI:1669579314
Name:MOODY, JOYCE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:MOODY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8802 VETERANS DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-2565
Mailing Address - Country:US
Mailing Address - Phone:253-584-9532
Mailing Address - Fax:
Practice Address - Street 1:PUGET SOUND HEALTH CARE SYSTEM AMERICAN LAKE DV
Practice Address - Street 2:9600 VETERANS DR. SW BLDG 61 B
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0001
Practice Address - Country:US
Practice Address - Phone:253-582-8440
Practice Address - Fax:253-589-4167
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000040011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical