| Joshua Marshall Licensed Clinical Social Worker Inc. | |
|
41945 Big Bear Blvd # 208 Big Bear Lake CA 92315-2030 | |
| (909) 351-0743 | |
| Not Available |
| Full Name | Joshua Marshall Licensed Clinical Social Worker Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 41945 Big Bear Blvd # 208, Big Bear Lake, California |
| Authorized Official Name and Position | Joshua James Marshall (CEO) |
| Authorized Official Contact | 9498929279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Marshall Licensed Clinical Social Worker Inc. 217 Crimson Cir Big Bear City CA 92314-9200 Ph: (949) 892-9279 | Joshua Marshall Licensed Clinical Social Worker Inc. 41945 Big Bear Blvd # 208 Big Bear Lake CA 92315-2030 Ph: (909) 351-0743 |
| NPI Number | 1124738034 |
|---|---|
| Provider Enumeration Date | 12/01/2022 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 5496105397 |
|---|---|
| Medicare Enrollment ID | O20231219000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124738034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joshua James Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588222400 PECOS PAC ID: 0446640429 Enrollment ID: I20231219000274 |
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