Provider Demographics
NPI:1376993931
Name:DUPUIE, JULIE ANN (BSW, LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:DUPUIE
Suffix:
Gender:F
Credentials:BSW, LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 W BRIARCLIFF KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4117
Mailing Address - Country:US
Mailing Address - Phone:248-808-0727
Mailing Address - Fax:
Practice Address - Street 1:9315 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-1260
Practice Address - Country:US
Practice Address - Phone:313-450-4500
Practice Address - Fax:313-450-0004
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68510996591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801099659Medicaid
MI6801099659Medicare PIN
6801099659Medicare UPIN
MI6801099659Medicare NSC
MI6801099659Medicaid
MI6801099659Medicare Oscar/Certification