Provider Demographics
NPI:1487015921
Name:HEIDI JOSLIN LLC
Entity type:Organization
Organization Name:HEIDI JOSLIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:775-990-9032
Mailing Address - Street 1:1611 W BLOSSER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89060-2919
Mailing Address - Country:US
Mailing Address - Phone:775-990-9032
Mailing Address - Fax:775-537-6347
Practice Address - Street 1:2220 NEVADA WEST BLVD
Practice Address - Street 2:SUITE 2 (A)
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5879
Practice Address - Country:US
Practice Address - Phone:775-990-9032
Practice Address - Fax:775-537-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6448-C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1Medicaid
NV800001752OtherMEDICARE NUMBER