Provider Demographics
NPI:1326072695
Name:ULM, LAWRENCE JOSEPH SR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:JOSEPH
Last Name:ULM
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:398 DIX RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-1407
Mailing Address - Country:US
Mailing Address - Phone:573-556-6299
Mailing Address - Fax:573-556-8577
Practice Address - Street 1:398 DIX RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1407
Practice Address - Country:US
Practice Address - Phone:573-556-6299
Practice Address - Fax:573-556-8577
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOSW001487104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO113744OtherCOUNSELING