Provider Demographics
NPI:1134490345
Name:FARMER, JULIA LORENA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:LORENA
Last Name:FARMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MORENA
Other - Last Name:SELINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1803 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265
Mailing Address - Country:US
Mailing Address - Phone:309-277-0167
Mailing Address - Fax:309-277-0163
Practice Address - Street 1:1803 7TH STREET
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-277-0167
Practice Address - Fax:309-277-0163
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149004740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker