| Doctor Name: | MR. JOSHUA ALLEN RUNTENELLI |
| NPI Number: | 1073955506 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LISW, LICDC |
| License Number: | I 1302876 |
| Business Practice Address: | 8559 S Mason Montgomery Rd Mason, OH - 450409381 |
| Business Phone Number: | 5132298980 |
| Business Fax Number: | 5132298935 |
| Mailing Address: | 1149 Fallbrook Dr, ELSMERE |
| State: | KY |
| Postal Code: | 410183700 |
| Phone Number: | 8598665514 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2013 |
| NPI Last Update Date: | 07/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I 1302876 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |