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General NPI Number Information
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NPI Number | 1629956123
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Entity Type | Individual
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Provider Name | JULIA ST JEAN LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 37 CAMP MOWEEN RD
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City | LEBANON
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State | CT
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Zip | 06249-2704
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Country | US
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Telephone | 860-294-9585
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Fax |
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Provider Business Mailing Address
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Address Line | 363 LAKE RD
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City | ANDOVER
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State | CT
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Zip | 06232-1515
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Country | US
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Telephone | 860-207-0212
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Fax | 860-207-0212
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11468
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License Number State | CT
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