Provider Demographics
NPI:1679959316
Name:DUFFY, JULIE ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:DUFFY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:PRITZL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N1185 REDWING DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8736
Mailing Address - Country:US
Mailing Address - Phone:920-284-0085
Mailing Address - Fax:
Practice Address - Street 1:N1185 REDWING DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-8736
Practice Address - Country:US
Practice Address - Phone:920-284-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WI6521-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1679959316Medicaid