Basic Information
Provider Information
NPI: 1467407171
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOND
FirstName: JOYCE
MiddleName: E
NamePrefix: MISS
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16874 ROBINSON RD
Address2:  
City: SILOAM SPRINGS
State: AR
PostalCode: 727618593
CountryCode: US
TelephoneNumber: 4794526650
FaxNumber: 4794525847
Practice Location
Address1: 3111 S 70TH ST
Address2:  
City: FORT SMITH
State: AR
PostalCode: 729035017
CountryCode: US
TelephoneNumber: 4794526650
FaxNumber: 4794525847
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X556CARY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home