Provider Demographics
NPI:1235395609
Name:LONCAR, JULIE B (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:B
Last Name:LONCAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:OLD MISSION
Mailing Address - State:MI
Mailing Address - Zip Code:49673-0097
Mailing Address - Country:US
Mailing Address - Phone:800-671-1767
Mailing Address - Fax:
Practice Address - Street 1:4996 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-9754
Practice Address - Country:US
Practice Address - Phone:800-671-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010577971041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP28120001Medicare PIN