Provider Demographics
NPI:1659729127
Name:MAGRUDER, JOSHUA (PHD, LPC-S, NCC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:MAGRUDER
Suffix:
Gender:M
Credentials:PHD, LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 INSIGHT PARK
Mailing Address - Street 2:STE. 163 A
Mailing Address - City:UNIVERSITY
Mailing Address - State:MS
Mailing Address - Zip Code:38677
Mailing Address - Country:US
Mailing Address - Phone:662-915-7197
Mailing Address - Fax:
Practice Address - Street 1:850 INSIGHT PARK
Practice Address - Street 2:STE. 163 A
Practice Address - City:UNIVERSITY
Practice Address - State:MS
Practice Address - Zip Code:38677
Practice Address - Country:US
Practice Address - Phone:662-915-7197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health