Provider Demographics
NPI:1083837561
Name:BAZUIN, JULIE RENEE (LMSW, CAADC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:RENEE
Last Name:BAZUIN
Suffix:
Gender:F
Credentials:LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 WASHINGTON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7725
Mailing Address - Country:US
Mailing Address - Phone:616-820-3780
Mailing Address - Fax:616-820-3785
Practice Address - Street 1:926 WASHINGTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7725
Practice Address - Country:US
Practice Address - Phone:616-820-3780
Practice Address - Fax:616-820-3785
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical