Provider Demographics
NPI:1558979849
Name:CAIN, JULIETTE MARIE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:JULIETTE
Middle Name:MARIE
Last Name:CAIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:JULIETTE
Other - Middle Name:MARIE
Other - Last Name:PEPION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 520
Mailing Address - Street 2:1105 SHELDON SOURAY AVENUE
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-0520
Mailing Address - Country:US
Mailing Address - Phone:701-477-3121
Mailing Address - Fax:701-477-8925
Practice Address - Street 1:1105 SHELDON SOURAY AVENUE
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-0520
Practice Address - Country:US
Practice Address - Phone:701-477-3121
Practice Address - Fax:701-477-8925
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)