Provider Demographics
NPI:1689851735
Name:LENZENDORF, JULIE ANN (CSAC 15261132)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:LENZENDORF
Suffix:
Gender:F
Credentials:CSAC 15261132
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:NALEPINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 W SUNNY LANE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546
Mailing Address - Country:US
Mailing Address - Phone:608-741-4500
Mailing Address - Fax:608-741-4502
Practice Address - Street 1:203 W SUNNY LANE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546
Practice Address - Country:US
Practice Address - Phone:608-741-4500
Practice Address - Fax:608-741-4516
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15261132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42247900Medicaid