Provider Demographics
NPI:1790299097
Name:KAUFMAN, JOSHUA JAMES (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:JAMES
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4382
Mailing Address - Country:US
Mailing Address - Phone:307-265-3977
Mailing Address - Fax:
Practice Address - Street 1:5725 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4382
Practice Address - Country:US
Practice Address - Phone:307-265-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1609101YP2500X
WYLPC-1609251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional