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General NPI Number Information
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NPI Number | 1225653652
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Entity Type | Individual
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Provider Name | JULIE RENEE ROY LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 808 W LAKE LANSING RD STE 200
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City | EAST LANSING
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State | MI
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Zip | 48823-6322
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Country | US
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Telephone | 517-618-9515
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Fax |
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Provider Business Mailing Address
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Address Line | 902 DARLINGTON AVE
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City | EAST LANSING
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State | MI
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Zip | 48823-1881
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Country | US
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Telephone | 517-290-0003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801115293
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License Number State | MI
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