Provider Demographics
NPI:1235611120
Name:HULTGREN, JULIA H (LSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:H
Last Name:HULTGREN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41479 COUNTRY ROSE CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-4569
Mailing Address - Country:US
Mailing Address - Phone:720-258-6518
Mailing Address - Fax:
Practice Address - Street 1:2210 E LA SALLE ST STE 220
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2303
Practice Address - Country:US
Practice Address - Phone:720-506-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical