Provider Demographics
NPI:1386601029
Name:BECKER, JOY E (APRN)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:E
Last Name:BECKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORTHBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1914
Mailing Address - Country:US
Mailing Address - Phone:508-393-7223
Mailing Address - Fax:508-393-7026
Practice Address - Street 1:112 MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NORTHBORO
Practice Address - State:MA
Practice Address - Zip Code:01532-1914
Practice Address - Country:US
Practice Address - Phone:508-393-7223
Practice Address - Fax:508-393-7026
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA908092163WP0809X
MARN90892364SP0809X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NS0086Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER