Healthcare Provider Details

I. General information

NPI: 1245635689
Provider Name (Legal Business Name): JULIA ANN DECANIO MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA ASKINAZI

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 REYKO RD STE 100
JACKSONVILLE FL
32207-2828
US

IV. Provider business mailing address

2055 REYKO RD STE 100
JACKSONVILLE FL
32207-2828
US

V. Phone/Fax

Practice location:
  • Phone: 904-648-8200
  • Fax: 904-253-3270
Mailing address:
  • Phone: 904-648-8200
  • Fax: 904-253-3270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBP02943721
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20399
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: