Provider Demographics
NPI:1972153575
Name:JOSIAH, LEAH (DSW,LCSW,CASAC,CARC)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:JOSIAH
Suffix:
Gender:F
Credentials:DSW,LCSW,CASAC,CARC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PATERSON PLANK RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3416
Mailing Address - Country:US
Mailing Address - Phone:201-503-5151
Mailing Address - Fax:
Practice Address - Street 1:500 PATERSON PLANK RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3416
Practice Address - Country:US
Practice Address - Phone:201-503-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30929101YA0400X
NY0936321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid