Provider Demographics
NPI:1124045190
Name:NIVER, JULIA K (MS, CADC III)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:NIVER
Suffix:
Gender:F
Credentials:MS, CADC III
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:K
Other - Last Name:HALLORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2209 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:WI
Mailing Address - Zip Code:53073-4281
Mailing Address - Country:US
Mailing Address - Phone:920-892-7606
Mailing Address - Fax:920-449-4247
Practice Address - Street 1:2209 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:WI
Practice Address - Zip Code:53073-4281
Practice Address - Country:US
Practice Address - Phone:920-892-7606
Practice Address - Fax:920-449-4247
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2322101YA0400X
WI3459-125101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3978990Medicaid
13648OtherNETWORK HEALTH PLAN
390806395OtherCIGNA