Provider Demographics
NPI:1326073198
Name:FARMER, DENISE JANE (LMSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:JANE
Last Name:FARMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6975 EATON RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-9302
Mailing Address - Country:US
Mailing Address - Phone:517-888-3592
Mailing Address - Fax:855-421-1773
Practice Address - Street 1:180 W MICHIGAN AVE STE 802
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201
Practice Address - Country:US
Practice Address - Phone:517-888-3592
Practice Address - Fax:855-421-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010860281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM12180Medicare ID - Type UnspecifiedMEDICARE