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General NPI Number Information
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NPI Number | 1558176131
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Entity Type | Organization
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Legal Business Name | JULIE URSIC LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 2309 PACIFIC COAST HWY STE 202
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2753
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Country | US
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Telephone | 310-528-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 1429 W 16TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-4003
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Country | US
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Telephone | 310-528-5007
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE ROSE URSIC
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Credential | JD, LCSW
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Telephone | 310-528-5007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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