Provider Demographics
NPI:1982395679
Name:BEARE, JOSHUA (CSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BEARE
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N THORNTON ST STE H
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-5508
Mailing Address - Country:US
Mailing Address - Phone:575-935-4411
Mailing Address - Fax:575-935-0400
Practice Address - Street 1:1200 N THORNTON ST STE H
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-5508
Practice Address - Country:US
Practice Address - Phone:575-935-4411
Practice Address - Fax:575-935-0400
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator