Provider Demographics
NPI:1508354242
Name:BROWN, JOSHUA MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 GROVER ST STE 308
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3618
Mailing Address - Country:US
Mailing Address - Phone:402-577-0357
Mailing Address - Fax:402-625-0499
Practice Address - Street 1:6818 GROVER ST STE 308
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3618
Practice Address - Country:US
Practice Address - Phone:402-577-0357
Practice Address - Fax:402-625-0499
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NE958103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist