Provider Demographics
NPI:1942851613
Name:NIELSEN, JULIE ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:WERDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9205 W 90TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3814
Mailing Address - Country:US
Mailing Address - Phone:913-787-7214
Mailing Address - Fax:
Practice Address - Street 1:20 W 9TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-1704
Practice Address - Country:US
Practice Address - Phone:913-787-7214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018044111104100000X
KS10277104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty