Provider Demographics
NPI:1700903853
Name:JOSLIN, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:JOSLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 CHARM CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6801
Mailing Address - Country:US
Mailing Address - Phone:512-627-8501
Mailing Address - Fax:
Practice Address - Street 1:896 ROBIN RANCH RD
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-4578
Practice Address - Country:US
Practice Address - Phone:512-376-2101
Practice Address - Fax:512-398-5696
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15506101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1407454-01Medicaid
TX1407454-02Medicaid