Basic Information
| Provider Information | |||||||||
| NPI: | 1285143727 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIMMEL | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 SHAWNEE DR | ||||||||
| Address2: | |||||||||
| City: | NORTH EAST | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219014212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4843631126 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2057 PULASKI HWY STE 4 | ||||||||
| Address2: | |||||||||
| City: | NORTH EAST | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219013744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438774044 | ||||||||
| FaxNumber: | 4439670077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2017 | ||||||||
| LastUpdateDate: | 09/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701005972 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.