Healthcare Provider Details

I. General information

NPI: 1427406875
Provider Name (Legal Business Name): JULIE HOPE KOTOWICZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 01/22/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25-10 30TH AVE
ASTORIA NY
11102
US

IV. Provider business mailing address

30-14 CRESCENT ST SOCIAL WORK
ASTORIA NY
11102
US

V. Phone/Fax

Practice location:
  • Phone: 718-267-4273
  • Fax: 706-227-7249
Mailing address:
  • Phone: 718-570-3558
  • Fax: 706-227-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number100081-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW006644
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: