Provider Demographics
NPI:1114756616
Name:SCHUBACH, JULIE (LSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SCHUBACH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MIEBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2704 BOULDER DR STE B
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-7832
Mailing Address - Country:US
Mailing Address - Phone:217-607-1678
Mailing Address - Fax:
Practice Address - Street 1:2704 BOULDER DR STE B
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-7832
Practice Address - Country:US
Practice Address - Phone:217-607-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker