1093068587 NPI number — DR. JULIE ANN REESE DBH, LCSW

Table of content: DR. JULIE ANN REESE DBH, LCSW (NPI 1093068587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093068587 NPI number — DR. JULIE ANN REESE DBH, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REESE
Provider First Name:
JULIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DBH, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REESE
Provider Other First Name:
JULIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DBH, LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1093068587
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 MDG, UNIT 3215
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAMSTEIN AB
Provider Business Mailing Address State Name:
PROVINCE
Provider Business Mailing Address Postal Code:
APO AE 09094
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
86 MDG, UNIT 3215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAMSTEIN
Provider Business Practice Location Address State Name:
PROVINCE
Provider Business Practice Location Address Postal Code:
APO AE 09094
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
623-696-2949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  13666 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LCSW-15438 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13666 . This is a "LICENSED MASTER OF SOCIAL WORK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com