Provider Demographics
NPI:1508364217
Name:VAAL, JOSHUA GRANT (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:GRANT
Last Name:VAAL
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 WETHERSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-8700
Mailing Address - Country:US
Mailing Address - Phone:812-453-4202
Mailing Address - Fax:
Practice Address - Street 1:1146 WASHINGTON SQ
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-6809
Practice Address - Country:US
Practice Address - Phone:812-425-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007889A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical