Provider Demographics
NPI:1487837076
Name:GARRETT, JULIE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:M
Last Name:GARRETT
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 1:5839 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-8124
Mailing Address - Country:US
Mailing Address - Phone:918-671-1267
Mailing Address - Fax:
Practice Address - Street 1:4157 S HARVARD AVE STE 121
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2606
Practice Address - Country:US
Practice Address - Phone:918-671-1267
Practice Address - Fax:918-488-0119
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200349520AMedicaid