Provider Demographics
NPI:1578047106
Name:STOLL, JOSHUA (LGPC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:STOLL
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 SOUTHERLY RD APT 421
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2645
Mailing Address - Country:US
Mailing Address - Phone:717-991-5205
Mailing Address - Fax:
Practice Address - Street 1:7903 ORION CIR # D234
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-3101
Practice Address - Country:US
Practice Address - Phone:240-898-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8815101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor