Provider Demographics
NPI:1679533749
Name:PREUSCH, JULIA WHITE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:WHITE
Last Name:PREUSCH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 COTTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801
Mailing Address - Country:US
Mailing Address - Phone:641-782-8457
Mailing Address - Fax:641-782-7048
Practice Address - Street 1:1003 COTTONWOOD RD
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801
Practice Address - Country:US
Practice Address - Phone:641-782-8457
Practice Address - Fax:641-782-7048
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI14457Medicare ID - Type Unspecified