Provider Demographics
NPI:1699514588
Name:CARELOCK, JOYCE L (MHC INTERN)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:L
Last Name:CARELOCK
Suffix:
Gender:F
Credentials:MHC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 KETZAL DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7239
Mailing Address - Country:US
Mailing Address - Phone:703-801-3287
Mailing Address - Fax:
Practice Address - Street 1:7552 CONGRESS ST # 206
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-1106
Practice Address - Country:US
Practice Address - Phone:727-301-7231
Practice Address - Fax:727-517-1046
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health