Provider Demographics
NPI:1467122895
Name:RECORDS, JULIE C (LICSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:RECORDS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:COONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3395 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-3633
Mailing Address - Country:US
Mailing Address - Phone:952-548-8657
Mailing Address - Fax:
Practice Address - Street 1:1200 MARQUETTE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2419
Practice Address - Country:US
Practice Address - Phone:612-790-9029
Practice Address - Fax:612-503-1980
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN255651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical