Provider Demographics
NPI:1588107650
Name:JOY COUNSELING & PLAY THERAPY
Entity type:Organization
Organization Name:JOY COUNSELING & PLAY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-540-8631
Mailing Address - Street 1:102 MARY ALICE PARK RD STE 504
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2697
Mailing Address - Country:US
Mailing Address - Phone:770-540-8631
Mailing Address - Fax:
Practice Address - Street 1:102 MARY ALICE PARK RD STE 504
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2697
Practice Address - Country:US
Practice Address - Phone:770-540-8631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty