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Individual

JASON MACKALL JOYCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PCC-S, LCDC III

Contact information

Practice address
6811 HIGHLAND DR, INDEPENDENCE, OH 44131-6318
(740) 317-3997
Mailing address
6811 HIGHLAND DR, INDEPENDENCE, OH 44131-6318
(740) 317-3997

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OH
101YP2500X
Professional Counselor
Primary
C-0500521
OH

Other

Enumeration date
11/07/2006
Last updated
12/17/2010
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