Provider Demographics
NPI:1942612924
Name:FISCHMAN, JULIANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:FISCHMAN
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:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:HAILEY
Mailing Address - State:ID
Mailing Address - Zip Code:83333-0549
Mailing Address - Country:US
Mailing Address - Phone:208-720-2057
Mailing Address - Fax:
Practice Address - Street 1:314 S RIVER ST STE 202
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333-7503
Practice Address - Country:US
Practice Address - Phone:208-720-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID323421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical