Provider Demographics
NPI:1154487767
Name:PARTIN, JULIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:PARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 S GLENSTONE AVE STE H
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1513
Mailing Address - Country:US
Mailing Address - Phone:417-881-9518
Mailing Address - Fax:417-887-2051
Practice Address - Street 1:1722 S GLENSTONE AVE STE H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1513
Practice Address - Country:US
Practice Address - Phone:417-881-9518
Practice Address - Fax:417-887-2051
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040208751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical