Provider Demographics
NPI:1619254901
Name:SHEETS, JOSHUA ASHTON (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ASHTON
Last Name:SHEETS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5034
Mailing Address - Country:US
Mailing Address - Phone:336-349-4454
Mailing Address - Fax:336-349-5186
Practice Address - Street 1:621 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320
Practice Address - Country:US
Practice Address - Phone:336-349-4454
Practice Address - Fax:336-349-5186
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical