MEDICARE: JULIE K BARTHELS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149-010239	IL

General Provider Information

NPI Number	:	1821235672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE K BARTHELS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 2069
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61130-0069
Country	:	US
Telephone Number	:	815-289-7513
Fax Number	:

Provider Business Practice Location Address
First Line	:	8459 CREEKWAY LN
Second Line	:
City	:	MACHESNEY PARK
State	:	IL
Zip	:	61115-2731
Country	:	US
Telephone Number	:	815-289-7513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	05/13/2021

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