MEDICARE: JULIE SPEARS, LCSW, LLC

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
1	1041C0700X	Clinical Social Worker	36349	TX

General Provider Information

NPI Number	:	1326592296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE SPEARS, LCSW, LLC

Provider Business Mailing Address
First Line	:	706 W BEN WHITE BLVD STE 180
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-8124
Country	:	US
Telephone Number	:	512-497-4782
Fax Number	:

Provider Business Practice Location Address
First Line	:	4422 PACK SADDLE PASS
Second Line	:	SUITE 103
City	:	AUSTIN
State	:	TX
Zip	:	78745-1681
Country	:	US
Telephone Number	:	512-497-4782
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIE SPEARS
Credential	:	LCSW
Telephone Number	:	512-497-4782

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	10/06/2022

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