Provider Demographics
NPI:1184969768
Name:VARNER, MICHELE NICOLE (MSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:NICOLE
Last Name:VARNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:NICOLE
Other - Last Name:PHILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3452
Mailing Address - Country:US
Mailing Address - Phone:812-206-1370
Mailing Address - Fax:812-206-1410
Practice Address - Street 1:460 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3452
Practice Address - Country:US
Practice Address - Phone:812-206-1370
Practice Address - Fax:812-206-1410
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical