Provider Demographics
NPI:1134336449
Name:PAPANEK, JOHN M (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:PAPANEK
Suffix:
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:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-2587
Mailing Address - Country:US
Mailing Address - Phone:502-451-3330
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 419
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4837
Practice Address - Country:US
Practice Address - Phone:502-409-6993
Practice Address - Fax:502-409-6775
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1888104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker