Provider Demographics
NPI:1083230155
Name:BAROCIO, JUAN MANUEL JR (T-LMSW)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:MANUEL
Last Name:BAROCIO
Suffix:JR
Gender:M
Credentials:T-LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:NORTH NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67117-8105
Mailing Address - Country:US
Mailing Address - Phone:559-903-5050
Mailing Address - Fax:
Practice Address - Street 1:301 N MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3460
Practice Address - Country:US
Practice Address - Phone:559-903-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11697104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker