Provider Demographics
NPI:1619163821
Name:FRIESEN, JULIA (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:FRIESEN
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 1:27W341 SUNNYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1446
Mailing Address - Country:US
Mailing Address - Phone:312-965-3715
Mailing Address - Fax:630-230-4232
Practice Address - Street 1:27W140 ROOSEVELT RD
Practice Address - Street 2:STE 206
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1642
Practice Address - Country:US
Practice Address - Phone:312-965-3715
Practice Address - Fax:630-230-4232
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0084561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical