Healthcare Provider Details

I. General information

NPI: 1477287571
Provider Name (Legal Business Name): JULIA K POOLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3295 N DRINKWATER BLVD STE 10
SCOTTSDALE AZ
85251-6437
US

IV. Provider business mailing address

2501 N HAYDEN RD STE 103
SCOTTSDALE AZ
85257-2326
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-2703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-19167
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-22083
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: