Healthcare Provider Details

I. General information

NPI: 1447638440
Provider Name (Legal Business Name): JOSHUA THOMAS PAUL LPC CSAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 FOURIER DRIVE SUITE 200
MADISON WI
53717-1958
US

IV. Provider business mailing address

1001 FOURIER DR STE 200
MADISON WI
53717-1958
US

V. Phone/Fax

Practice location:
  • Phone: 608-740-2001
  • Fax: 608-740-2002
Mailing address:
  • Phone: 608-740-2001
  • Fax: 608-740-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16054
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6314
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: