Basic Information
| Provider Information | |||||||||
| NPI: | 1669579314 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOODY | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW, LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8802 VETERANS DR SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984982565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535849532 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | PUGET SOUND HEALTH CARE SYSTEM AMERICAN LAKE DV | ||||||||
| Address2: | 9600 VETERANS DR. SW BLDG 61 B | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984930001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535828440 | ||||||||
| FaxNumber: | 2535894167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 1041C0700X | LW00004001 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.