Healthcare Provider Details

I. General information

NPI: 1467889964
Provider Name (Legal Business Name): JULIA SOTILE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S MAIN ST SUITE 204
DAVIDSON NC
28036-8039
US

IV. Provider business mailing address

PO BOX 2290
DAVIDSON NC
28036-5290
US

V. Phone/Fax

Practice location:
  • Phone: 704-989-8428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008264
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: