Provider Demographics
NPI:1841642725
Name:SHIELDS, JOYCE DAQNAL (PMHCNS-BC CGP)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:DAQNAL
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:PMHCNS-BC CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 OAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2734
Mailing Address - Country:US
Mailing Address - Phone:617-645-4959
Mailing Address - Fax:
Practice Address - Street 1:132 OAKLEY RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2734
Practice Address - Country:US
Practice Address - Phone:617-645-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN121047364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult