Provider Demographics
NPI:1205992211
Name:CARLSON, JULIE ANN (LMSW, LMHC, CADC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LMSW, LMHC, CADC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 93RD ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-6222
Mailing Address - Country:US
Mailing Address - Phone:515-321-1300
Mailing Address - Fax:515-285-5657
Practice Address - Street 1:4700 93RD ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-6222
Practice Address - Country:US
Practice Address - Phone:515-321-1300
Practice Address - Fax:515-285-5657
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40067101YA0400X
IA696101YM0800X
IA28961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical