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NPI 1558829952

NPI 1558829952 : JOSHUA BARADALE COLLINS LCSW, LCADC : NEW BRUNSWICK, NJ

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General NPI Number Information
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    NPI Number           |    1558829952
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA BARADALE COLLINS LCSW, LCADC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/05/2019
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    Last Update Date     |    12/05/2025
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Provider Practice Location Address
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    Address Line         |    104 BAYARD ST 
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    City                 |    NEW BRUNSWICK
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    State                |    NJ
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    Zip                  |    08901-2389
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    Country              |    US
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    Telephone            |    732-847-2869
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    804 PORTER WAY W 
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    City                 |    BRIDGEWATER
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    State                |    NJ
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    Zip                  |    08807-3538
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    Country              |    US
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    Telephone            |    732-307-3730
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    44SC05955200
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    37LC00330700
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    License Number State |    NJ
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