Provider Demographics
NPI:1992566319
Name:IMBIEROWSKI, JULIA ELLEN (LPC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ELLEN
Last Name:IMBIEROWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 W PLUM TREE CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-2656
Mailing Address - Country:US
Mailing Address - Phone:716-345-9541
Mailing Address - Fax:
Practice Address - Street 1:10150 W PLUM TREE CIR APT 103
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2656
Practice Address - Country:US
Practice Address - Phone:716-345-9541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8502-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional