Keturah Jolene Farmer, LCSW

Individual provider Active NPI Social Worker · West Plains, MO

NPI 1376197822 · NPPES record last updated Jul 13, 2022

Key facts

NPI
1376197822
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
2019029468 (MO)
Practice address
504 W Main St
West Plains, MO 65775-2732
Phone
(417) 252-0846
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220422001759 MO Practitioner - Clinical Social Worker 4688061567

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2019029468MOMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2019029468 MO Yes

Addresses

Primary practice location

504 W Main St
West Plains, MO 65775-2732

Mailing address

PO Box 1475
West Plains, MO 65775-1475
Phone (417) 815-4769

Other practice location 1

1211 Porter Wagoner Blvd, Ste. 23
West Plains, MO 65775
Phone (417) 257-6762

Other providers in West Plains, MO

All providers in West Plains, MO · Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.