Provider Demographics
NPI:1982005286
Name:CARR, JULIE ANN
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSP,MSHHA
Mailing Address - Street 1:1826 218TH ST
Mailing Address - Street 2:
Mailing Address - City:SAUK VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60411-4442
Mailing Address - Country:US
Mailing Address - Phone:708-560-3762
Mailing Address - Fax:
Practice Address - Street 1:3615 PARK DR
Practice Address - Street 2:SUITE 203B
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1186
Practice Address - Country:US
Practice Address - Phone:630-506-6321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health