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NPI Code Detail

MEDICARE: JULIA ANN DECANIO MSW, LCSW

MEDICARE: JULIA ANN DECANIO MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerBP02943721WV
21041C0700XClinical Social WorkerSW20399FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245635689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA ANN DECANIO MSW, LCSW
Provider Business Mailing Address
First Line : 2055 REYKO RD STE 100
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-2828
Country : US
Telephone Number : 904-648-8200
Fax Number : 904-253-3270
Provider Business Practice Location Address
First Line : 2055 REYKO RD STE 100
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-2828
Country : US
Telephone Number : 904-648-8200
Fax Number : 904-253-3270
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2014
Last Update Date : 05/12/2026

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