Provider Demographics
NPI:1518240811
Name:SHARTLE, JULIE DEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DEAN
Last Name:SHARTLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 WINDERMERE OAKS E
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3138
Mailing Address - Country:US
Mailing Address - Phone:985-285-6468
Mailing Address - Fax:985-340-8066
Practice Address - Street 1:600 N HIGHWAY 190
Practice Address - Street 2:SUITE 207
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5003
Practice Address - Country:US
Practice Address - Phone:985-285-6468
Practice Address - Fax:985-340-8066
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical