Basic Information
Provider Information
NPI: 1003998543
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALK
FirstName: JULIE
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: LSCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 327 SW FRAZIER AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 666061963
CountryCode: US
TelephoneNumber: 7852325005
FaxNumber: 7852324098
Practice Location
Address1: 327 SW FRAZIER AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 666061963
CountryCode: US
TelephoneNumber: 7852325005
FaxNumber: 7852324098
Other Information
ProviderEnumerationDate: 10/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X2355KSY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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