Joshua Shane Wiseman, LICDC
Counselor, Addiction (Substance Use Disorder) in Columbus, OH. Individual provider (NPI-1).
NPI number1669960449
StatusActive
Last updated in NPPESSep 17, 2020
Details
- NPI
- 1669960449
- Entity type
- Individual (NPI-1)
- Name
- Joshua Shane Wiseman
- Credential
- LICDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2018
- Certification date
- Sep 17, 2020
- Last updated
- Sep 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | LICDC.162064 | OH | Yes |
Practice location
4725 Parkwick DrColumbus, OH 43228-6401
Phone 614-655-3354
Mailing address
4725 Parkwick DrColumbus, OH 43228-6401
Phone 614-655-3354
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