Healthcare Provider Details

I. General information

NPI: 1730983750
Provider Name (Legal Business Name): JULIE KRUPACS, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8133 FOREST HILL AVE STE 301
NORTH CHESTERFIELD VA
23235-3254
US

IV. Provider business mailing address

600 BANCROFT AVE
RICHMOND VA
23222-2811
US

V. Phone/Fax

Practice location:
  • Phone: 804-822-5780
  • Fax:
Mailing address:
  • Phone: 804-822-5780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE KRUPACS
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 804-822-5780