Individual
JOSHUA GINGERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1501 SAN PEDRO DR SE # 87108, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
1501 SAN PEDRO DR SE # 87108, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
85-0338552
NM
104100000X
Social Worker
X-09656
NM
1041C0700X
Clinical Social Worker
Primary
C-10810
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902918055
—
NM
Enumeration date
08/17/2015
Last updated
10/22/2021
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