Provider Demographics
NPI:1639211303
Name:ATABE, JULIE A (MSE, LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:ATABE
Suffix:
Gender:F
Credentials:MSE, LPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSE, LPC
Mailing Address - Street 1:777 29TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2357
Mailing Address - Country:US
Mailing Address - Phone:920-209-9149
Mailing Address - Fax:
Practice Address - Street 1:2140 MEADOW SWEET LN
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-6501
Practice Address - Country:US
Practice Address - Phone:920-209-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3360-125101YP2500X
AZLPC-22571101YP2500X
COLPC.0016604101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC.0016604OtherSTATE OF CO LPC LICENSE
WI41009400Medicaid
WI3360-125OtherSTATE OF WI LPC LICENSURE
AZLPC-22571OtherSTATE OF AZ LPC LICENSE