Healthcare Provider Details

I. General information

NPI: 1194496034
Provider Name (Legal Business Name): JOSHUA ADAM DAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SE 2ND AVE
GRAND RAPIDS MN
55744-3615
US

IV. Provider business mailing address

2620 STEIN BLVD STE B
EAU CLAIRE WI
54701-2674
US

V. Phone/Fax

Practice location:
  • Phone: 218-326-1274
  • Fax: 218-326-9787
Mailing address:
  • Phone: 715-836-0064
  • Fax: 715-836-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC04735
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: