Basic Information
| Provider Information | |||||||||
| NPI: | 1790266070 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEHSTEN | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 316 GRANDVIEW BLVD | ||||||||
| Address2: | |||||||||
| City: | ADA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458101662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192966455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 525 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ADA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458101025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194228616 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2018 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I.2103306 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 104100000X | S.1802782 | OH | N | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.