Healthcare Provider Details

I. General information

NPI: 1013805282
Provider Name (Legal Business Name): JOHN LEON HUFSTEDLER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 N CROSS POINTE BLVD
EVANSVILLE IN
47715-4010
US

IV. Provider business mailing address

PO BOX 632281
CINCINNATI OH
45263-2281
US

V. Phone/Fax

Practice location:
  • Phone: 812-471-4611
  • Fax: 812-471-4514
Mailing address:
  • Phone: 812-450-6822
  • Fax: 812-450-6815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34008898A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: