Provider Demographics
NPI:1881174530
Name:LEET, JULIE E (MSW, LCSW, CT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:LEET
Suffix:
Gender:F
Credentials:MSW, LCSW, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9135 N MERIDIAN ST STE A6
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1815
Mailing Address - Country:US
Mailing Address - Phone:317-679-3316
Mailing Address - Fax:317-581-1471
Practice Address - Street 1:9135 N MERIDIAN ST STE A6
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1815
Practice Address - Country:US
Practice Address - Phone:317-679-3316
Practice Address - Fax:317-581-1471
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004610A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical