Provider Demographics
NPI:1407010408
Name:DODES, JOSHUA E (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:E
Last Name:DODES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S 4TH ST
Mailing Address - Street 2:SUITE 250B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1570
Mailing Address - Country:US
Mailing Address - Phone:646-543-9510
Mailing Address - Fax:
Practice Address - Street 1:525 S 4TH ST
Practice Address - Street 2:SUITE 250B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1570
Practice Address - Country:US
Practice Address - Phone:646-543-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0185061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical