=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942836507
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA WARNICA LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2020
-----------------------------------------------------
Last Update Date | 03/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 E TEXAS BLVD
-----------------------------------------------------
City | DALHART
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79022-4321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-249-8324
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1500 S VIRGINIA ST APT A
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79102-2289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-567-4127
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 62811
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------