Healthcare Provider Details

I. General information

NPI: 1417406240
Provider Name (Legal Business Name): JOSHUA J. CRICK L.C.S.W., L.C.A.D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4326 US 1
MONMOUTH JUNCTION NJ
08852
US

IV. Provider business mailing address

49 NEW RD
KENDALL PARK NJ
08824-1160
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-5000
  • Fax:
Mailing address:
  • Phone: 322-905-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00246600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05921600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: