Provider Demographics
NPI:1043647977
Name:LARGUSA-STEPHENS, JOSHUA K (BS OF PSYCHOLGY)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:K
Last Name:LARGUSA-STEPHENS
Suffix:
Gender:M
Credentials:BS OF PSYCHOLGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 BEDFORDSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7370
Mailing Address - Country:US
Mailing Address - Phone:702-499-5353
Mailing Address - Fax:
Practice Address - Street 1:3960 EAST PATRICK LANE SUITE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4902
Practice Address - Country:US
Practice Address - Phone:702-998-6264
Practice Address - Fax:702-998-6270
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1604718566101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor