Provider Demographics
NPI:1538399514
Name:DOHERTY, JOELLE EMILY (LMHC)
Entity type:Individual
Prefix:MS
First Name:JOELLE
Middle Name:EMILY
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 STANWAY PL W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3329
Mailing Address - Country:US
Mailing Address - Phone:561-338-0315
Mailing Address - Fax:
Practice Address - Street 1:7780 STANWAY PL W
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3329
Practice Address - Country:US
Practice Address - Phone:561-338-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health