Individual
JOSHUA CHARLES ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2019031646
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490078915
—
MO
Enumeration date
11/14/2019
Last updated
12/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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