Healthcare Provider Details

I. General information

NPI: 1508564022
Provider Name (Legal Business Name): JULIA DEGROOTH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 WASHINGTON ST
NEWTON MA
02458-1626
US

IV. Provider business mailing address

313 WASHINGTON ST
NEWTON MA
02458-1626
US

V. Phone/Fax

Practice location:
  • Phone: 857-557-8323
  • Fax:
Mailing address:
  • Phone: 857-557-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2390809
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2390809
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: