Provider Demographics
NPI:1245646298
Name:LANDIN, JOSHUA (MA, CMHC, LPC-I)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:LANDIN
Suffix:
Gender:M
Credentials:MA, CMHC, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NE HIGHWAY 99W
Mailing Address - Street 2:STE H
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-2757
Mailing Address - Country:US
Mailing Address - Phone:541-740-2864
Mailing Address - Fax:
Practice Address - Street 1:1900 NE HIGHWAY 99W
Practice Address - Street 2:STE H
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-2757
Practice Address - Country:US
Practice Address - Phone:541-740-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR3373101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor