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NPI Code Detail

MEDICARE: JULIE SMITH ACKERMAN LISW CP

MEDICARE: JULIE SMITH ACKERMAN LISW CP
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 Worker0904008487VA
21041C0700XClinical Social Worker15839SC

General Provider Information

NPI Number : 1952725699
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE SMITH ACKERMAN LISW CP
Provider Business Mailing Address
First Line : 3580 JOSEPH SIEWICK DR STE 5
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1717
Country : US
Telephone Number : 703-391-4574
Fax Number :
Provider Business Practice Location Address
First Line : 1320 MAIN ST STE 300
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-3266
Country : US
Telephone Number : 657-237-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2014
Last Update Date : 06/30/2023

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