Provider Demographics
NPI:1568887834
Name:FARR, JULIE (LSCSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:LSCSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21108 E CEDAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MO
Mailing Address - Zip Code:64734-9264
Mailing Address - Country:US
Mailing Address - Phone:816-618-3194
Mailing Address - Fax:
Practice Address - Street 1:21108 E CEDAR RIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MO
Practice Address - Zip Code:64734-9264
Practice Address - Country:US
Practice Address - Phone:816-618-3194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120387691041C0700X
KS41161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical