Provider Demographics
NPI:1942547278
Name:JUESCHKE, JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:JUESCHKE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 SPECKER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4263
Mailing Address - Country:US
Mailing Address - Phone:719-503-7831
Mailing Address - Fax:719-503-7884
Practice Address - Street 1:6541 SPECKER AVE
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4263
Practice Address - Country:US
Practice Address - Phone:719-503-7831
Practice Address - Fax:719-503-7884
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099231271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical