MEDICARE: JULIE ANNE BROUHARD LMSW

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	6801091900	MI

General Provider Information

NPI Number	:	1841577731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANNE BROUHARD LMSW

Provider Business Mailing Address
First Line	:	136 HIGHLAND DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0357
Country	:	US
Telephone Number	:	248-517-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 HIGHLAND DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0357
Country	:	US
Telephone Number	:	248-517-3300
Fax Number	:

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

Provider Enumeration Date	:	11/07/2011
Last Update Date	:	02/08/2025

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