Provider Demographics
NPI:1558778324
Name:BEHNKE, JULIE MARIE (MSW, CSAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:BEHNKE
Suffix:
Gender:F
Credentials:MSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 WEST POINT RD.
Mailing Address - Street 2:PO BOX 365
Mailing Address - City:GEEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54155-0365
Mailing Address - Country:US
Mailing Address - Phone:920-490-3857
Mailing Address - Fax:920-490-3858
Practice Address - Street 1:2640 W POINT RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-1344
Practice Address - Country:US
Practice Address - Phone:204-903-8579
Practice Address - Fax:920-490-3858
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15612-131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)