Provider Demographics
NPI:1497808810
Name:BELISLE, JULIANE CHRISTINE (LISW)
Entity type:Individual
Prefix:MRS
First Name:JULIANE
Middle Name:CHRISTINE
Last Name:BELISLE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JULIANE
Other - Middle Name:CHRISTINE
Other - Last Name:BELISLE-CALLAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:591 BOSTON MILLS RD STE 550
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1160
Mailing Address - Country:US
Mailing Address - Phone:234-269-6200
Mailing Address - Fax:234-602-2192
Practice Address - Street 1:591 BOSTON MILLS RD STE 550
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1160
Practice Address - Country:US
Practice Address - Phone:234-269-6200
Practice Address - Fax:234-602-2192
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00092181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCA9240062Medicare ID - Type UnspecifiedGROUP IDENTIFICATION