=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679125587
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE MCCALIP LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2019
-----------------------------------------------------
Last Update Date | 10/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1173 W MAIN ST
-----------------------------------------------------
City | WHITEWATER
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53190-1672
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-302-0140
-----------------------------------------------------
Fax | 262-458-2680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 N WUTHERING HILLS DR
-----------------------------------------------------
City | JANESVILLE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53546-2104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-302-0140
-----------------------------------------------------
Fax | 262-458-2680
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------