Provider Demographics
NPI:1942465794
Name:FAHLMANN, JULIE K (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:FAHLMANN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 BURGOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT EDWARD
Mailing Address - State:NY
Mailing Address - Zip Code:12828-1137
Mailing Address - Country:US
Mailing Address - Phone:518-747-2121
Mailing Address - Fax:518-747-0951
Practice Address - Street 1:2 CLARK STREET
Practice Address - Street 2:HUDSON FALLS CENTRAL SCHOOL-MMM KINDERGARTEN CENTER
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839
Practice Address - Country:US
Practice Address - Phone:518-681-4500
Practice Address - Fax:518-747-3853
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420800Medicaid