=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992256093
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE M STRASESKE LPCIT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2016
-----------------------------------------------------
Last Update Date | 12/13/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | W175N11120 STONEWOOD DR
-----------------------------------------------------
City | GERMANTOWN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53022-6511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-438-1772
-----------------------------------------------------
Fax | 262-293-9737
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | W175N11120 STONEWOOD DR
-----------------------------------------------------
City | GERMANTOWN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53022-6511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-438-1772
-----------------------------------------------------
Fax | 262-293-9727
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 3298-226
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 7618-125
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------