Provider Demographics
NPI:1760142384
Name:HEROLD, JOSHUA RAY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:RAY
Last Name:HEROLD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-0080
Mailing Address - Country:US
Mailing Address - Phone:515-371-9414
Mailing Address - Fax:
Practice Address - Street 1:1100 7TH ST BLDG 7
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2503
Practice Address - Country:US
Practice Address - Phone:515-697-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110416104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker