Provider Demographics
NPI:1538555230
Name:KRAUS, JULIE (LPC, LSW, SUDC, SSW)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:LPC, LSW, SUDC, SSW
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:SMITH
Other - Last Name:KRAUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LSW, SUDC, SSW
Mailing Address - Street 1:3522 BRIAR CREEK LN
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-4728
Mailing Address - Country:US
Mailing Address - Phone:208-529-1660
Mailing Address - Fax:208-529-1699
Practice Address - Street 1:655 S 4TH E STE 100
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:ID
Practice Address - Zip Code:83263-1616
Practice Address - Country:US
Practice Address - Phone:208-529-1660
Practice Address - Fax:208-529-1699
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-5691101YP2500X
UT138645-3503104100000X
IDLSW-29915101YM0800X, 104100000X
UTSUDC 138645-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID452899613Medicaid