Provider Demographics
NPI:1578129110
Name:GROAH, JOSHUA DANIEL (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:GROAH
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 SPENCERVILLE CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1653
Mailing Address - Country:US
Mailing Address - Phone:717-333-1494
Mailing Address - Fax:
Practice Address - Street 1:15300 SPENCERVILLE CT
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1653
Practice Address - Country:US
Practice Address - Phone:717-333-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD213071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical