Provider Demographics
NPI:1285931915
Name:BOCKENSTEDT, JULIE KAY WILLIAMS (PHD, LISW, LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY WILLIAMS
Last Name:BOCKENSTEDT
Suffix:
Gender:F
Credentials:PHD, LISW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 KIMBERLY RD STE 300S
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3555
Mailing Address - Country:US
Mailing Address - Phone:563-343-0500
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 300S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3555
Practice Address - Country:US
Practice Address - Phone:563-343-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0224721041C0700X
IA062561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.022472OtherLCSW
IA06256OtherLICENSED INDEPENDENT SOCIAL WORKER