Provider Demographics
NPI:1841577731
Name:BROUHARD, JULIE ANNE (LMSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:BROUHARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:LONGSTREET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:136 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0357
Mailing Address - Country:US
Mailing Address - Phone:248-517-3300
Mailing Address - Fax:
Practice Address - Street 1:136 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0357
Practice Address - Country:US
Practice Address - Phone:248-517-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010919001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical