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General NPI Number Information
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NPI Number | 1801117882
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Entity Type | Individual
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Provider Name | JOSHUA A EBERLE LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 4730 BECKNER ROAD
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City | SANTA FE
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State | NM
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Zip | 87507-3691
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Country | US
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Telephone | 55-989-4500
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Fax | 505-443-8313
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Provider Business Mailing Address
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Address Line | 2960 RODEO PARK DR W
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City | SANTA FE
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State | NM
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Zip | 87505-6351
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Country | US
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Telephone |
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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 | 082916-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L7021
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-11749
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License Number State | NM
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