Provider Demographics
NPI:1700547056
Name:BONGANG, JOYCE JUMNI (LPC, NCC, CCMHC)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:JUMNI
Last Name:BONGANG
Suffix:
Gender:F
Credentials:LPC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7222 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-5156
Mailing Address - Country:US
Mailing Address - Phone:912-675-2746
Mailing Address - Fax:
Practice Address - Street 1:306 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3685
Practice Address - Country:US
Practice Address - Phone:912-436-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional