Provider Demographics
NPI:1669510129
Name:PRICE, JULIET KAREN (LCSW, DCSW, QCSW)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:KAREN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW, DCSW, QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1275
Mailing Address - Country:US
Mailing Address - Phone:708-738-3678
Mailing Address - Fax:
Practice Address - Street 1:5009 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1275
Practice Address - Country:US
Practice Address - Phone:708-738-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical