Provider Demographics
NPI:1467932392
Name:WARE, JOSHUA IMMANUEL (LMSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:IMMANUEL
Last Name:WARE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 LEFFERTS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1301
Mailing Address - Country:US
Mailing Address - Phone:718-493-0300
Mailing Address - Fax:718-493-6166
Practice Address - Street 1:840 LEFFERTS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1301
Practice Address - Country:US
Practice Address - Phone:718-493-0300
Practice Address - Fax:718-493-6166
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1024421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical