Provider Demographics
NPI:1700459112
Name:KAPLAN, JOSHUA (CADC II (COUNSELOR))
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:CADC II (COUNSELOR)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-4331
Mailing Address - Country:US
Mailing Address - Phone:901-517-7471
Mailing Address - Fax:
Practice Address - Street 1:8830 CENTRE ST STE 5
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2609
Practice Address - Country:US
Practice Address - Phone:662-510-2523
Practice Address - Fax:662-510-2527
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAD21-010K101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)