Provider Demographics
NPI:1497160774
Name:FIGUEROA, JUAN JR (LCSW)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:FIGUEROA
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 DORSEY LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2612
Mailing Address - Country:US
Mailing Address - Phone:502-245-1576
Mailing Address - Fax:502-245-8973
Practice Address - Street 1:1015 DORSEY LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2612
Practice Address - Country:US
Practice Address - Phone:502-245-1576
Practice Address - Fax:502-245-8973
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2544931041C0700X
NMX-104571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM24489557Medicaid