Provider Demographics
NPI:1194276824
Name:BERNSEN, JULIE E (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:BERNSEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1361
Mailing Address - Country:US
Mailing Address - Phone:847-525-2910
Mailing Address - Fax:
Practice Address - Street 1:2851 S PARKER RD STE 570
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2749
Practice Address - Country:US
Practice Address - Phone:720-535-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004093235Z00000X
TX114406235Z00000X
UT9774723-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14179248OtherASHA