Healthcare Provider Details

I. General information

NPI: 1740723048
Provider Name (Legal Business Name): JULIE EIMERS LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 N OAKLAND AVE
MILWAUKEE WI
53211
US

IV. Provider business mailing address

528 GRIFFITH ST
LAKE MILLS WI
53551-1025
US

V. Phone/Fax

Practice location:
  • Phone: 414-465-8217
  • Fax:
Mailing address:
  • Phone: 920-728-5594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17567-130
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3071-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: