Basic Information
| Provider Information | |||||||||
| NPI: | 1619428117 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANK | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LCSW, LSW, ACD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 262 COTTONWOOD CREEK RD | ||||||||
| Address2: | |||||||||
| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813016160 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 281 SAWYER DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813033409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703352281 | ||||||||
| FaxNumber: | 9702475255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2016 | ||||||||
| LastUpdateDate: | 11/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | ACD.0000901 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 104100000X | 0009921865 | CO | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 09925559 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.