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General NPI Number Information
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NPI Number | 1588222400
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Entity Type | Individual
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Provider Name | JOSHUA JAMES MARSHALL LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 41945 BIG BEAR BLVD # 208
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City | BIG BEAR LAKE
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State | CA
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Zip | 92315-2030
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Country | US
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Telephone | 909-351-0742
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Fax |
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Provider Business Mailing Address
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Address Line | 217 CRIMSON CIR
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City | BIG BEAR CITY
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State | CA
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Zip | 92314-9200
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Country | US
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Telephone | 949-892-9279
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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 | 88153
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License Number State | CA
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