Healthcare Provider Details

I. General information

NPI: 1437815891
Provider Name (Legal Business Name): JULIE MAY DEINES LMSW, CRADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 SOUTH AVE
SPRINGFIELD MO
65807-5220
US

IV. Provider business mailing address

977 CEASAR HOLLOW RD
GALENA MO
65656-8254
US

V. Phone/Fax

Practice location:
  • Phone: 417-889-5483
  • Fax:
Mailing address:
  • Phone: 417-655-5781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10609
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2026039586
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: