Provider Demographics
NPI:1730261694
Name:HESTER, JULIE ANN (MSW)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:HESTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:MERTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1027 N SHAKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-8792
Mailing Address - Country:US
Mailing Address - Phone:262-646-5378
Mailing Address - Fax:262-646-5383
Practice Address - Street 1:888 THACKERAY TRL STE 211
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4342
Practice Address - Country:US
Practice Address - Phone:414-659-6635
Practice Address - Fax:262-567-1481
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6751211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39773500Medicaid
WI39773500Medicaid