Provider Demographics
NPI:1487330676
Name:MAGOLD, JOSH ALLAN I (MA)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:ALLAN
Last Name:MAGOLD
Suffix:I
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15940 HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487-5946
Mailing Address - Country:US
Mailing Address - Phone:708-927-4052
Mailing Address - Fax:
Practice Address - Street 1:4545 S 86TH ST # NE68526
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9262
Practice Address - Country:US
Practice Address - Phone:402-483-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist