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NPI Code Detail

MEDICARE: JULIE IVEY LMSW,, LCDC.

MEDICARE: JULIE IVEY LMSW,, LCDC.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor7745TX
2104100000XSocial Worker32529TX

General Provider Information

NPI Number : 1588802268
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE IVEY LMSW,, LCDC.
Provider Business Mailing Address
First Line : 24891 HIGHWAY 6
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-7747
Country : US
Telephone Number : 800-869-8552
Fax Number : 713-869-8564
Provider Business Practice Location Address
First Line : 24891 HIGHWAY 6
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-7747
Country : US
Telephone Number : 800-869-8552
Fax Number : 713-869-8564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2009
Last Update Date : 02/03/2009

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