Individual
MRS. JULIA LYNN STATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED CLINICAL SO
Contact information
Practice address
3219 NORTH MAIN, HAZARD, KY 41702
(606) 487-8657
(606) 439-0931
Mailing address
3219 NORTH MAIN, PO BOX 485, HAZARD, KY 41702
(606) 487-8657
(606) 439-0931
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
955
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000043034
ANTHEM BC BS
—
01
—
237158
MHN HMC
—
05
—
8200956
—
KY
01
—
84421
MAGELLAN
—
Enumeration date
03/26/2007
Last updated
03/25/2013
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