Provider Demographics
NPI:1437996246
Name:MADSEN, JULIE (MPS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MADSEN
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 41ST AVE NE UNIT 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-4600
Mailing Address - Country:US
Mailing Address - Phone:612-286-5106
Mailing Address - Fax:
Practice Address - Street 1:5861 CEDAR LAKE ROAD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-202-8703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health