MEDICARE: HEIDI JOSLIN LLC

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
1	251S00000X	Community/Behavioral Health Agency	6448-C	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	800001752	OTHER	NV	MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487015921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIDI JOSLIN LLC

Provider Business Mailing Address
First Line	:	1611 W BLOSSER RANCH RD
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89060-2919
Country	:	US
Telephone Number	:	775-990-9032
Fax Number	:	775-537-6347

Provider Business Practice Location Address
First Line	:	2220 NEVADA WEST BLVD
Second Line	:	SUITE 2 (A)
City	:	PAHRUMP
State	:	NV
Zip	:	89048-5879
Country	:	US
Telephone Number	:	775-990-9032
Fax Number	:	775-537-6347

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	HEIDI JOSLIN
Credential	:	LCSW
Telephone Number	:	775-990-9032

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	03/11/2016

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Directions to “HEIDI JOSLIN LLC ” Practice Location

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