Provider Demographics
NPI:1659102069
Name:BRAINARD, JOSHUA DUNCAN (LMHC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DUNCAN
Last Name:BRAINARD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N BLAIR ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1201
Mailing Address - Country:US
Mailing Address - Phone:765-918-0777
Mailing Address - Fax:
Practice Address - Street 1:106 N BLAIR ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1201
Practice Address - Country:US
Practice Address - Phone:765-918-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004690A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health