Healthcare Provider Details

I. General information

NPI: 1801454574
Provider Name (Legal Business Name): JULIE BERNSTEIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DUNDEE PARK DR STE 202B
ANDOVER MA
01810-3768
US

IV. Provider business mailing address

2 DUNDEE PARK DR BLDG 2
ANDOVER MA
01810-3735
US

V. Phone/Fax

Practice location:
  • Phone: 617-803-2851
  • Fax: 978-409-9006
Mailing address:
  • Phone: 617-852-4268
  • Fax: 978-409-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIE BERNSTEIN
Title or Position: CLINICAL SOCIAL WORKER
Credential: LICSW
Phone: 617-803-2851