Basic Information
Provider Information | |||||||||
NPI: | 1932247871 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FORCIER | ||||||||
FirstName: | JOY | ||||||||
MiddleName: | LEACH | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | LICSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 725 UNIVERSITY BLVD | ||||||||
Address2: |   | ||||||||
City: | FAIRBORN | ||||||||
State: | OH | ||||||||
PostalCode: | 453242640 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9372457200 | ||||||||
FaxNumber: | 9372457999 | ||||||||
Practice Location | |||||||||
Address1: | 725 UNIVERSITY BLVD | ||||||||
Address2: |   | ||||||||
City: | FAIRBORN | ||||||||
State: | OH | ||||||||
PostalCode: | 453242640 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9372457200 | ||||||||
FaxNumber: | 9372457999 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/02/2007 | ||||||||
LastUpdateDate: | 03/21/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1.1501026CSW | OH | Y |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
ID | Type | State | Issuer | Description | 457771 | 01 | MA | TUFTS HEALTH PLAN | OTHER | PO5612 | 01 | MA | BLUE CROSS AND BLUE SHIEL | OTHER |