Provider Demographics
NPI:1811487176
Name:JOSHUA 1 DEVELOPMENT & SOCIAL SERVICES
Entity type:Organization
Organization Name:JOSHUA 1 DEVELOPMENT & SOCIAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER/MASTERS INSTRUCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CID
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CSW, CSSW
Authorized Official - Phone:732-742-4224
Mailing Address - Street 1:23 MATTHEW AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-2843
Mailing Address - Country:US
Mailing Address - Phone:732-742-4224
Mailing Address - Fax:
Practice Address - Street 1:23 MATTHEW AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2843
Practice Address - Country:US
Practice Address - Phone:732-742-4224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSHUA 1 DEVELOPMENT & SOCIAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-12
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 106E00000X, 171M00000X, 171R00000X
NJ6121311041S0200X
NJ44SW05293100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty