Basic Information
| Provider Information | |||||||||
| NPI: | 1275844458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COURT | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 WEST AVE S | ||||||||
| Address2: | |||||||||
| City: | LA CROSSE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546014783 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087850940 | ||||||||
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| Practice Location | |||||||||
| Address1: | 212 11TH ST S | ||||||||
| Address2: | |||||||||
| City: | LA CROSSE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546014116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6083929555 | ||||||||
| FaxNumber: | 6083929432 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2010 | ||||||||
| LastUpdateDate: | 06/23/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 7636 | WI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.