Provider Demographics
NPI:1033772918
Name:FARNSWORTH, BILLIE JO JERGINS (SSW)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JO JERGINS
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:SSW
Other - Prefix:
Other - First Name:BILLIE, JOEY
Other - Middle Name:JO
Other - Last Name:JERGINS, GILLESPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SSW
Mailing Address - Street 1:282 SOUTH 400 WEST
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737
Mailing Address - Country:US
Mailing Address - Phone:435-773-8079
Mailing Address - Fax:
Practice Address - Street 1:245 E 680 S
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3593
Practice Address - Country:US
Practice Address - Phone:435-867-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10885857-3503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker