Healthcare Provider Details

I. General information

NPI: 1598687295
Provider Name (Legal Business Name): JOSHUA FRANK WAYNE LMSW, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 LINWOOD AVE NE STE 300
ATLANTA GA
30306-4437
US

IV. Provider business mailing address

67 LAFAYETTE DR NE APT 4
ATLANTA GA
30309-3353
US

V. Phone/Fax

Practice location:
  • Phone: 404-781-9247
  • Fax:
Mailing address:
  • Phone: 770-377-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMSW013175
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: