MEDICARE: MR. JOSHUA DOUGLAS CULBERTSON LPCC

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	101Y00000X	Counselor	E.2002046	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RR388795	OTHER	OH	OHIO DRIVER'S LICENSE

General Provider Information

NPI Number	:	1588104137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA DOUGLAS CULBERTSON LPCC

Provider Business Mailing Address
First Line	:	3048 COLUMBUS LANCASTER RD NW
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-8125
Country	:	US
Telephone Number	:	614-706-0975
Fax Number	:

Provider Business Practice Location Address
First Line	:	3048 COLUMBUS LANCASTER RD NW
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-8125
Country	:	US
Telephone Number	:	614-706-0975
Fax Number	:

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

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	04/28/2021

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