Healthcare Provider Details

I. General information

NPI: 1730284662
Provider Name (Legal Business Name): JULIE ANNE HOVRUD MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 BARRETT DR SUITE 201
RALEIGH NC
27609-6622
US

IV. Provider business mailing address

4010 BARRETT DR SUITE 201
RALEIGH NC
27609-6622
US

V. Phone/Fax

Practice location:
  • Phone: 919-810-0858
  • Fax: 919-900-8182
Mailing address:
  • Phone: 919-810-0858
  • Fax: 919-900-8182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005394
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: