Provider Demographics
NPI:1073219705
Name:BEUSCHLEIN, JULIETA CAROLINA (MA)
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:CAROLINA
Last Name:BEUSCHLEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 WINDGATE CT
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1848
Mailing Address - Country:US
Mailing Address - Phone:773-206-5252
Mailing Address - Fax:
Practice Address - Street 1:3755 E MAIN ST STE 185
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2423
Practice Address - Country:US
Practice Address - Phone:630-549-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health