Provider Demographics
NPI:1649663907
Name:SWIM, JULIE D (LISW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:SWIM
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DAWN
Other - Last Name:BAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1407 GRANDIN RD APT 4104
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9415
Mailing Address - Country:US
Mailing Address - Phone:303-886-4356
Mailing Address - Fax:
Practice Address - Street 1:10200 ALLIANCE RD STE 150
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-4754
Practice Address - Country:US
Practice Address - Phone:303-886-4356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20771041C0700X
KY2594681041C0700X
OHI.23047021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47-3333652OtherEMPLOYEE INDENTIFICATION NUMBER