Provider Demographics
NPI:1710245048
Name:BARNES -ULLRICH, EARLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:EARLEY
Middle Name:
Last Name:BARNES -ULLRICH
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:PO BOX 1863
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78646-1863
Mailing Address - Country:US
Mailing Address - Phone:737-215-8655
Mailing Address - Fax:
Practice Address - Street 1:12001 W PARMER LN STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7764
Practice Address - Country:US
Practice Address - Phone:737-215-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical