Provider Demographics
NPI:1851517296
Name:HEESE, JULIE RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RAE
Last Name:HEESE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7132 E MOUNT HOPE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-7620
Mailing Address - Country:US
Mailing Address - Phone:573-355-7118
Mailing Address - Fax:
Practice Address - Street 1:2401 BERNADETTE DR STE 206
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4672
Practice Address - Country:US
Practice Address - Phone:573-355-7118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0015691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical