Provider Demographics
NPI:1942768825
Name:JULIE B. LESTER LICSW LLC
Entity Type:Organization
Organization Name:JULIE B. LESTER LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:509-240-0135
Mailing Address - Street 1:30 W MAIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2872
Mailing Address - Country:US
Mailing Address - Phone:509-240-0135
Mailing Address - Fax:
Practice Address - Street 1:30 W MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2872
Practice Address - Country:US
Practice Address - Phone:509-240-0135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1124459748Medicaid
WA1093209413Medicaid