Healthcare Provider Details

I. General information

NPI: 1083230155
Provider Name (Legal Business Name): JUAN MANUEL BAROCIO JR. LSCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106A W 24TH ST
NORTH NEWTON KS
67117-8073
US

IV. Provider business mailing address

106A W 24TH ST PO BOX 262
NORTH NEWTON KS
67117-8073
US

V. Phone/Fax

Practice location:
  • Phone: 316-804-7240
  • Fax: 316-444-1804
Mailing address:
  • Phone: 316-804-7240
  • Fax: 316-444-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7191
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: