Provider Demographics
NPI:1932573839
Name:CACERES-LUND, BARBARA TS (CADC, ICADC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:TS
Last Name:CACERES-LUND
Suffix:
Gender:F
Credentials:CADC, ICADC
Other - Prefix:MR
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:CACERES-LUND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC, ICADC
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-0726
Mailing Address - Country:US
Mailing Address - Phone:859-721-1634
Mailing Address - Fax:
Practice Address - Street 1:3439 BUCKHORN DR STE 160
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-1721
Practice Address - Country:US
Practice Address - Phone:859-721-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY # 0863101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)