Provider Demographics
NPI:1790026862
Name:WILLIAMS, JULIE (MED)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:10101 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3848
Mailing Address - Country:US
Mailing Address - Phone:502-558-9086
Mailing Address - Fax:
Practice Address - Street 1:600 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-589-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1435101YM0800X
KY161513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health