Provider Demographics
NPI:1972370781
Name:JUAREZ, STEPHANIE H (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:H
Last Name:JUAREZ
Suffix:
Gender:F
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:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:LUTCHER
Mailing Address - State:LA
Mailing Address - Zip Code:70071-0338
Mailing Address - Country:US
Mailing Address - Phone:225-398-6883
Mailing Address - Fax:225-258-8114
Practice Address - Street 1:1876 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LUTCHER
Practice Address - State:LA
Practice Address - Zip Code:70071-5120
Practice Address - Country:US
Practice Address - Phone:225-398-6883
Practice Address - Fax:225-258-8114
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA93861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical