MEDICARE: MR. JOSHUA RAFAEL VAZQUEZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW026451	PA

General Provider Information

NPI Number	:	1003789272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA RAFAEL VAZQUEZ LCSW

Provider Business Mailing Address
First Line	:	1425 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2317
Country	:	US
Telephone Number	:	267-292-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2317
Country	:	US
Telephone Number	:	267-292-9313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	03/20/2026

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