Basic Information
| Provider Information | |||||||||
| NPI: | 1831476811 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOYCE C. DAY, PH.D., LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 N MAIN ST | ||||||||
| Address2: | ABBY PARK BLG. SUITE 3N | ||||||||
| City: | SOUTHINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064892537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602885400 | ||||||||
| FaxNumber: | 8602885100 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 N MAIN ST | ||||||||
| Address2: | ABBY PARK BLG. SUITE 3N | ||||||||
| City: | SOUTHINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064892537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602885400 | ||||||||
| FaxNumber: | 8602885100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2011 | ||||||||
| LastUpdateDate: | 03/07/2012 | ||||||||
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| AuthorizedOfficialLastName: | DAY | ||||||||
| AuthorizedOfficialFirstName: | JOYCE | ||||||||
| AuthorizedOfficialMiddleName: | CEREJO | ||||||||
| AuthorizedOfficialTitleorPosition: | SCHOOL PSYCHOLOGIST/LPC | ||||||||
| AuthorizedOfficialTelephone: | 86028854000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 001642 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 1003148099 | 01 | CT | NPI TYPE I ID | OTHER |