Provider Demographics
NPI:1700157583
Name:JULIE RUDIGER, LCSW, INC.
Entity Type:Organization
Organization Name:JULIE RUDIGER, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDIGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-331-1811
Mailing Address - Street 1:445 UNION BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228
Mailing Address - Country:US
Mailing Address - Phone:303-331-1811
Mailing Address - Fax:
Practice Address - Street 1:445 UNION BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1237
Practice Address - Country:US
Practice Address - Phone:303-331-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992023261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health