Healthcare Provider Details

I. General information

NPI: 1457868838
Provider Name (Legal Business Name): JULIA HEALY, MSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2018
Last Update Date: 01/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2458 CHRISTIAN ST STE 2200
WHITE RIVER JUNCTION VT
05001-9887
US

IV. Provider business mailing address

2458 CHRISTIAN ST STE 2200
WHITE RIVER JUNCTION VT
05001-9887
US

V. Phone/Fax

Practice location:
  • Phone: 802-356-9393
  • Fax:
Mailing address:
  • Phone: 802-356-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JULIA HEALY
Title or Position: SOLE MEMBER
Credential: MSW, LICSW
Phone: 802-356-9393