Provider Demographics
NPI:1053001495
Name:ANDERSON, JOI NOEL (LMSW)
Entity type:Individual
Prefix:MS
First Name:JOI
Middle Name:NOEL
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JOI
Other - Middle Name:
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:3995 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4125
Mailing Address - Country:US
Mailing Address - Phone:229-583-5103
Mailing Address - Fax:
Practice Address - Street 1:3995 HOLLAND DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4125
Practice Address - Country:US
Practice Address - Phone:229-583-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011149104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker