Healthcare Provider Details

I. General information

NPI: 1891212338
Provider Name (Legal Business Name): JOSHUA SPRUILL LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18TH MEDICAL GROUP UNIT 5268
APO AP
96368-5217
US

IV. Provider business mailing address

18TH MDG
APO AP
96368-5217
US

V. Phone/Fax

Practice location:
  • Phone: 315-634-0344
  • Fax:
Mailing address:
  • Phone: 315-634-0433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26343
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: