MEDICARE: MRS. JULNA CORRIELUS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW016080	PA
2	1041C0700X	Clinical Social Worker	118277	MA
3	1041S0200X	School Social Worker	00362126	NJ
4	1041C0700X	Clinical Social Worker	44SC05280100	NJ

General Provider Information

NPI Number	:	1861515942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULNA CORRIELUS LCSW

Provider Business Mailing Address
First Line	:	525 ROUTE 73 N STE 302
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 ROUTE 73 N STE 100
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3422
Country	:	US
Telephone Number	:	833-494-6724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	04/21/2025

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