Provider Demographics
NPI:1821067869
Name:SEVICK, JULIE A LUNDE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A LUNDE
Last Name:SEVICK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1906
Mailing Address - Country:US
Mailing Address - Phone:218-786-5410
Mailing Address - Fax:218-786-1561
Practice Address - Street 1:530 E 2ND ST
Practice Address - Street 2:DULUTH CLINIC FITNESS AND THERAPY CENTER
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805
Practice Address - Country:US
Practice Address - Phone:218-786-1561
Practice Address - Fax:218-786-1561
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4629103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN510022400Medicaid
MN478M1LUOtherBCBS OF MN
MN680002100Medicare ID - Type Unspecified