Provider Demographics
NPI:1376250456
Name:BRALEY, JULIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BRALEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:1542 16TH ST W STE 300
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-3888
Mailing Address - Country:US
Mailing Address - Phone:701-200-8113
Mailing Address - Fax:
Practice Address - Street 1:1542 16TH ST W STE 300
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-3888
Practice Address - Country:US
Practice Address - Phone:701-200-8113
Practice Address - Fax:701-572-2480
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6537104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker