Provider Demographics
NPI:1730407255
Name:LACLAIR, FRANCIS H JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:H
Last Name:LACLAIR
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:FRANC
Other - Middle Name:
Other - Last Name:LACLAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1717 DIXIE HWY
Mailing Address - Street 2:STE 412
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2766
Mailing Address - Country:US
Mailing Address - Phone:513-445-3638
Mailing Address - Fax:859-818-0796
Practice Address - Street 1:1717 DIXIE HWY
Practice Address - Street 2:STE 412
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2766
Practice Address - Country:US
Practice Address - Phone:513-445-3638
Practice Address - Fax:859-818-0796
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33901041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1730407255OtherNPI
KY610661458OtherGROUP TAX ID NUMBER