Healthcare Provider Details

I. General information

NPI: 1497679781
Provider Name (Legal Business Name): JULIA MARIE DEEDY X LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 JERICHO TPKE STE 100
JERICHO NY
11753-1346
US

IV. Provider business mailing address

420 JERICHO TPKE STE 100
JERICHO NY
11753-1346
US

V. Phone/Fax

Practice location:
  • Phone: 516-882-4544
  • Fax:
Mailing address:
  • Phone: 516-882-4544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131936
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: