Healthcare Provider Details

I. General information

NPI: 1831020148
Provider Name (Legal Business Name): JOSHUA JACOB EADES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W 4TH ST
DULUTH MN
55806-2719
US

IV. Provider business mailing address

221 W 4TH ST
DULUTH MN
55806-2719
US

V. Phone/Fax

Practice location:
  • Phone: 218-879-1227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5600
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: