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NPI Code Detail

MEDICARE: JOSHUA MUSTAIN

MEDICARE: JOSHUA MUSTAIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1184278343
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MUSTAIN
Provider Business Mailing Address
First Line : 115 HABERSHAM DR STE C
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-7353
Country : US
Telephone Number : 770-461-9944
Fax Number :
Provider Business Practice Location Address
First Line : 115 HABERSHAM DR STE C
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-7353
Country : US
Telephone Number : 770-461-9944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2019
Last Update Date : 07/26/2019

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Directions to “ JOSHUA MUSTAIN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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