Provider Demographics
NPI:1396467700
Name:MANN, JULIE ANN (LMSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MANN
Suffix:
Gender:F
Credentials:LMSW
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 63
Mailing Address - Street 2:
Mailing Address - City:TRIPOLI
Mailing Address - State:IA
Mailing Address - Zip Code:50676-0063
Mailing Address - Country:US
Mailing Address - Phone:319-464-0571
Mailing Address - Fax:
Practice Address - Street 1:8 CADILLAC DR STE 230
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5392
Practice Address - Country:US
Practice Address - Phone:641-394-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3373104100000X
MN76177104100000X
IA077793104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker