Provider Demographics
NPI:1174991889
Name:HOGAN, JULIE K (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 W STATE ST # 180
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-3924
Mailing Address - Country:US
Mailing Address - Phone:208-830-4237
Mailing Address - Fax:
Practice Address - Street 1:1775 W STATE ST # 180
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-3924
Practice Address - Country:US
Practice Address - Phone:208-536-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID35047101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health