1730407255 NPI number — MR. FRANCIS H LACLAIR JR. LCSW

Table of content: MR. FRANCIS H LACLAIR JR. LCSW (NPI 1730407255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730407255 NPI number — MR. FRANCIS H LACLAIR JR. LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LACLAIR
Provider First Name:
FRANCIS
Provider Middle Name:
H
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LACLAIR
Provider Other First Name:
FRANC
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1730407255
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 DIXIE HWY
Provider Second Line Business Mailing Address:
STE 412
Provider Business Mailing Address City Name:
FT WRIGHT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41011-2766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-445-3638
Provider Business Mailing Address Fax Number:
859-818-0796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 DIXIE HWY
Provider Second Line Business Practice Location Address:
STE 412
Provider Business Practice Location Address City Name:
FT WRIGHT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41011-2766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-445-3638
Provider Business Practice Location Address Fax Number:
859-818-0796
Provider Enumeration Date:
05/07/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  3390 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1730407255 . This is a "NPI" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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