Provider Demographics
NPI:1790237279
Name:HATFIELD, JULIE (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ELDREDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2484 N STOKESBERRY PL STE 150
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6084
Mailing Address - Country:US
Mailing Address - Phone:208-391-6504
Mailing Address - Fax:208-649-2805
Practice Address - Street 1:2484 N STOKESBERRY PL STE 150
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-6084
Practice Address - Country:US
Practice Address - Phone:208-391-6504
Practice Address - Fax:208-649-2805
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-370681041C0700X
IDLCSW-373731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical