Provider Demographics
NPI:1790547909
Name:HUFFMAN, AUSTIN (CSW)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W MAIN ST APT 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2059
Mailing Address - Country:US
Mailing Address - Phone:804-814-9393
Mailing Address - Fax:
Practice Address - Street 1:409 W NEW CIRCLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1832
Practice Address - Country:US
Practice Address - Phone:859-800-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2587041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical