Provider Demographics
NPI:1467108225
Name:JULIE FAHLMANN
Entity Type:Organization
Organization Name:JULIE FAHLMANN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAHLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-R
Authorized Official - Phone:518-288-6030
Mailing Address - Street 1:25 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12803-5354
Mailing Address - Country:US
Mailing Address - Phone:518-288-6030
Mailing Address - Fax:
Practice Address - Street 1:25 NORTH RD
Practice Address - Street 2:
Practice Address - City:SOUTH GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12803-5354
Practice Address - Country:US
Practice Address - Phone:518-288-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty