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General NPI Number Information
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NPI Number | 1518355288
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Entity Type | Individual
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Provider Name | JULIE BALLEW PHD, LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 2831 FORT MISSOULA RD STE 301
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City | MISSOULA
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State | MT
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Zip | 59804-7479
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Country | US
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Telephone | 406-540-2779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 921
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City | MISSOULA
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State | MT
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Zip | 59806-0921
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Country | US
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Telephone | 406-540-2779
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11055
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | SWP-LCPC-LIC-11055
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SWP-LCPC-LIC-11055
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License Number State | MT
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