Healthcare Provider Details

I. General information

NPI: 1457952889
Provider Name (Legal Business Name): JULIA BLASZCZYK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 RICHEY AVE # 2B
OAKLYN NJ
08107-2304
US

IV. Provider business mailing address

430 RICHEY AVE # 2B
OAKLYN NJ
08107-2304
US

V. Phone/Fax

Practice location:
  • Phone: 609-380-3192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06661500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW026798
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: