Luis Javier Balcazar Jr.

Individual provider Active NPI Clinical Social Worker · West Lafayette, IN

NPI 1487055422 · NPPES record last updated Apr 29, 2016

Key facts

NPI
1487055422
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Phone
(765) 494-6995
Fax
(765) 496-2139
NPI assigned
Sep 9, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

601 Stadium Mall Dr
West Lafayette, IN 47907-2052

Mailing address

902 N Chauncey Ave
West Lafayette, IN 47906-2706

Other providers in West Lafayette, IN

All providers in West Lafayette, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.