Provider Demographics
NPI:1477863439
Name:NORDEAN, JOSHUA C
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:C
Last Name:NORDEAN
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 1:4709 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4730
Mailing Address - Country:US
Mailing Address - Phone:918-378-6154
Mailing Address - Fax:
Practice Address - Street 1:5842 HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:TN
Practice Address - Zip Code:37307-4734
Practice Address - Country:US
Practice Address - Phone:918-378-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health