Provider Demographics
NPI:1326105677
Name:MERTES, JULIE LYNN (LCSW, CADC I)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYNN
Last Name:MERTES
Suffix:
Gender:F
Credentials:LCSW, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1221
Mailing Address - Country:US
Mailing Address - Phone:503-545-7033
Mailing Address - Fax:
Practice Address - Street 1:2400 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1221
Practice Address - Country:US
Practice Address - Phone:503-545-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR08-03-24101YA0400X
ORL63211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)