Healthcare Provider Details

I. General information

NPI: 1598867194
Provider Name (Legal Business Name): JULIE LYNN AUGUSTINOVICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 HARCOURT RD
INDIANAPOLIS IN
46260-2036
US

IV. Provider business mailing address

8180 CLEARVISTA PKWY # 230
INDIANAPOLIS IN
46256-1661
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33005155A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34006118A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: