Provider Demographics
NPI:1962502765
Name:FALBAUM, JULIE BETH (MSW LMSW ACSW CAC-1)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BETH
Last Name:FALBAUM
Suffix:
Gender:F
Credentials:MSW LMSW ACSW CAC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35216 OLD TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1441
Mailing Address - Country:US
Mailing Address - Phone:248-661-6096
Mailing Address - Fax:248-737-1587
Practice Address - Street 1:1308 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2253
Practice Address - Country:US
Practice Address - Phone:734-451-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-02193101YA0400X
MI68010574481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical