Healthcare Provider Details

I. General information

NPI: 1730407255
Provider Name (Legal Business Name): FRANCIS H LACLAIR JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANC LACLAIR LCSW

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 DIXIE HWY STE 412
FT WRIGHT KY
41011-2766
US

IV. Provider business mailing address

1717 DIXIE HWY STE 412
FT WRIGHT KY
41011-2766
US

V. Phone/Fax

Practice location:
  • Phone: 513-445-3638
  • Fax: 859-818-0796
Mailing address:
  • Phone: 513-445-3638
  • Fax: 859-818-0796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3390
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: