Healthcare Provider Details

I. General information

NPI: 1619409463
Provider Name (Legal Business Name): JULIA M SALMON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA M PALOMINO LCSW

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 TALLEY RD
LEESBURG FL
34748-3426
US

IV. Provider business mailing address

2707 AUTUMN LN
EUSTIS FL
32726-2041
US

V. Phone/Fax

Practice location:
  • Phone: 352-315-7800
  • Fax: 352-315-7587
Mailing address:
  • Phone: 352-250-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 14347
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: