Provider Demographics
NPI:1114407533
Name:FIGUEROA, KEVIN (LICSW, MSW)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 MARTEL LN
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86 SAINT PAUL ST STE 213
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4958
Practice Address - Country:US
Practice Address - Phone:802-825-4812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01200251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical