Provider Demographics
NPI:1316228315
Name:KLINE, JULIE (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KLINE
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 W KENOSHA ST STE 222
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8955
Mailing Address - Country:US
Mailing Address - Phone:918-810-5779
Mailing Address - Fax:
Practice Address - Street 1:2604 W KENOSHA ST STE 222
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8955
Practice Address - Country:US
Practice Address - Phone:918-810-5779
Practice Address - Fax:918-992-6823
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK86001341041C0700X
OK39451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical