Provider Demographics
NPI:1013648120
Name:DAVIES, JOSHUA NICHOLAS
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:NICHOLAS
Last Name:DAVIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W STONEGATE BLVD STE 101-210
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1045
Mailing Address - Country:US
Mailing Address - Phone:331-241-6485
Mailing Address - Fax:
Practice Address - Street 1:3400 W STONEGATE BLVD STE 101-210
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1045
Practice Address - Country:US
Practice Address - Phone:331-241-6485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician