Provider Demographics
NPI:1699003525
Name:FORD, JULIE K (MSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:FORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:K
Other - Last Name:BEHRENWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:6728 VINING RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-9784
Mailing Address - Country:US
Mailing Address - Phone:616-225-8220
Mailing Address - Fax:616-225-8226
Practice Address - Street 1:6728 VINING RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-9784
Practice Address - Country:US
Practice Address - Phone:616-225-8220
Practice Address - Fax:616-225-8226
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010658051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical