Provider Demographics
NPI:1528796810
Name:PHILLIPS, JOSHUA PAUL (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SUE ANN CT APT A
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1394
Mailing Address - Country:US
Mailing Address - Phone:252-505-7155
Mailing Address - Fax:
Practice Address - Street 1:100 SUE ANN CT APT A
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1394
Practice Address - Country:US
Practice Address - Phone:252-505-7155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2025-05-16
Deactivation Date:2025-04-10
Deactivation Code:
Reactivation Date:2025-05-09
Provider Licenses
StateLicense IDTaxonomies
NCP0217031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical