Individual provider · NPI-1

Julie A Blythe, RN, MSW, LCSW, CCTP

Social Worker, Clinical · Springfield, IL

NPI number1700438678
StatusActive
Last updated in NPPESApr 13, 2021

Details

NPI
1700438678
Entity type
Individual (NPI-1)
Name
Julie A Blythe
Credential
RN, MSW, LCSW, CCTP
Sex
Female
Sole proprietor
No
Enumeration date
Jul 11, 2019
Certification date
Apr 13, 2021
Last updated
Apr 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical149023022ILYes

Other names

  • Julie A Wells (Former Name)

Practice location

901 N 1st St Ste 225
Springfield, IL 62702-3760

Phone 217-788-4065 · Fax 217-788-5562

Mailing address

Po Box 3428
Springfield, IL 62708-3428

Phone 217-788-4065 · Fax 217-788-4147

Other practice locations

620 N Walnut St
Springfield, IL 62702-4930

Phone 217-544-4631

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