Basic Information
| Provider Information | |||||||||
| NPI: | 1831409408 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MINCIELI-JOYCE | ||||||||
| FirstName: | TIFFANI | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 522 SHORE ROAD | ||||||||
| Address2: | APT 3D | ||||||||
| City: | LONG BEACH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186126901 | ||||||||
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| Practice Location | |||||||||
| Address1: | 175 FULTON AVENUE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | HEMPSTEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164855710 | ||||||||
| FaxNumber: | 5164854225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2010 | ||||||||
| LastUpdateDate: | 10/18/2010 | ||||||||
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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 | 104100000X | 081740 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.