Provider Demographics
NPI:1821208406
Name:WERNER, JULIE MARIE (MSW, LSW, QRP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:WERNER
Suffix:
Gender:F
Credentials:MSW, LSW, QRP
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LSW, QRP
Mailing Address - Street 1:112 OAKWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26554
Mailing Address - Country:US
Mailing Address - Phone:304-377-7774
Mailing Address - Fax:
Practice Address - Street 1:112 OAKWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-377-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQRP00048OtherCASE MANAGER