Provider Demographics
NPI:1649530742
Name:JOINER, BILLIE S
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:S
Last Name:JOINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 171ST ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2116
Mailing Address - Country:US
Mailing Address - Phone:773-981-5039
Mailing Address - Fax:
Practice Address - Street 1:1722 171ST ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2116
Practice Address - Country:US
Practice Address - Phone:773-981-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006821101YP2500X
IN39004209A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200275200AMedicaid
IN200880AMedicare PIN