Provider Demographics
NPI:1447035118
Name:BOCK, JOSHUA E (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:E
Last Name:BOCK
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4856 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5539
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:844-270-1824
Practice Address - Street 1:4856 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5539
Practice Address - Country:US
Practice Address - Phone:970-494-4200
Practice Address - Fax:844-270-1824
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X
COPSYC.00015484103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No172A00000XOther Service ProvidersDriver