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General NPI Number Information
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NPI Number | 1609303031
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Entity Type | Individual
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Provider Name | JOSHUA EASTLICK LPC
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Gender | Male
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 530 S WATER ST STE 3
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City | PLATTEVILLE
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State | WI
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Zip | 53818
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Country | US
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Telephone | 608-348-5088
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Fax | 608-348-3302
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Provider Business Mailing Address
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Address Line | 530 S WATER ST STE 3
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City | PLATTEVILLE
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State | WI
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Zip | 53818-3626
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Country | US
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Telephone | 608-348-5088
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Fax | 608-348-3302
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7299-125
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License Number State | WI
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