Basic Information
Provider Information
NPI: 1467888370
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REDDING
FirstName: JOSHUA
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1110 MONTGOMERY AVE
Address2:  
City: STAUNTON
State: VA
PostalCode: 244013968
CountryCode: US
TelephoneNumber: 3307584515
FaxNumber: 3307582862
Practice Location
Address1: 616 FAIRVIEW AVE
Address2:  
City: BLACKSBURG
State: VA
PostalCode: 240605722
CountryCode: US
TelephoneNumber: 5404664641
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/24/2013
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0701005421VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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