Provider Demographics
NPI:1679712046
Name:ELMENHURST, JULIE ANN (LICSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:ELMENHURST
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 N CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7160
Mailing Address - Country:US
Mailing Address - Phone:509-492-7400
Mailing Address - Fax:509-783-7539
Practice Address - Street 1:1030 N CENTER PKWY
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7160
Practice Address - Country:US
Practice Address - Phone:509-492-7400
Practice Address - Fax:509-783-7539
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 00009297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist