| Keturah Farmer, Lcsw, Llc | |
|
504 W Main St West Plains MO 65775-2732 | |
| (417) 815-4769 | |
| Not Available |
| Full Name | Keturah Farmer, Lcsw, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 504 W Main St, West Plains, Missouri |
| Authorized Official Name and Position | Keturah Farmer (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4172520846 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keturah Farmer, Lcsw, Llc Po Box 1475 West Plains MO 65775-1475 Ph: () - | Keturah Farmer, Lcsw, Llc 504 W Main St West Plains MO 65775-2732 Ph: (417) 815-4769 |
| NPI Number | 1184372831 |
|---|---|
| Provider Enumeration Date | 03/11/2022 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Medicare PECOS PAC ID | 4688069909 |
|---|---|
| Medicare Enrollment ID | O20220322003174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184372831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Keturah J Farmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376197822 PECOS PAC ID: 4688061567 Enrollment ID: I20220422001759 |
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