Provider Demographics
NPI:1346748696
Name:CLUE, JOSHUA BENJAMIN (BCABA, LABA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:BENJAMIN
Last Name:CLUE
Suffix:
Gender:
Credentials:BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 MEADOWCREST ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4814
Mailing Address - Country:US
Mailing Address - Phone:540-336-4897
Mailing Address - Fax:
Practice Address - Street 1:3433 BRAMBLETON AVE STE 201A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6527
Practice Address - Country:US
Practice Address - Phone:540-283-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000202106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst