1396705208 NPI number — JULEE E BARKAUSKAS MSW LCSW CADC

Table of content: JULEE E BARKAUSKAS MSW LCSW CADC (NPI 1396705208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396705208 NPI number — JULEE E BARKAUSKAS MSW LCSW CADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKAUSKAS
Provider First Name:
JULEE
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW CADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAPP
Provider Other First Name:
JULEE
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1396705208
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 HILLCREST AVE STE F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORKVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60560-1366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-373-4927
Provider Business Mailing Address Fax Number:
630-277-8354

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 HILLCREST AVE STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORKVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60560-1366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-373-4927
Provider Business Practice Location Address Fax Number:
630-882-8538
Provider Enumeration Date:
03/24/2006

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: 101YA0400X , with the licence number:  4989 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 149001115 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 113474 . This is a "MAGELLAN IP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04527698 . This is a "BCBS OF IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 114650000 . This is a "MAGELLAN MIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 190033 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32096 . This is a "MINNESOTA BOARD OF SOCIAL WORK" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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