Provider Demographics
NPI:1972092849
Name:GEBHARDT, JOSHUA DALE (LMFT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DALE
Last Name:GEBHARDT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 HIGHWAY 166
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-5066
Mailing Address - Country:US
Mailing Address - Phone:770-595-0689
Mailing Address - Fax:
Practice Address - Street 1:4321 HIGHWAY 166
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-5066
Practice Address - Country:US
Practice Address - Phone:404-482-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist