Provider Demographics
NPI:1053502963
Name:CANADY, JOSHUA ANDREW (LMHC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ANDREW
Last Name:CANADY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 S FIFE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2641
Mailing Address - Country:US
Mailing Address - Phone:206-388-5131
Mailing Address - Fax:206-452-0802
Practice Address - Street 1:2223 S MERIDIAN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-7503
Practice Address - Country:US
Practice Address - Phone:206-388-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health