MEDICARE: JULIA PURCARO LMFT, CASAC

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	106H00000X	Marriage & Family Therapist	001438	NY

General Provider Information

NPI Number	:	1902479306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA PURCARO LMFT, CASAC

Provider Business Mailing Address
First Line	:	141 E MAIN ST
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2852
Country	:	US
Telephone Number	:	631-760-1889
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 E MAIN ST STE 2
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2850
Country	:	US
Telephone Number	:	631-760-1889
Fax Number	:	631-760-1889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	04/11/2022

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