Provider Demographics
NPI:1003835380
Name:GONZALEZ, JULIA (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 HARMON DR
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1800
Mailing Address - Country:US
Mailing Address - Phone:914-834-2128
Mailing Address - Fax:914-834-2128
Practice Address - Street 1:2436 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5916
Practice Address - Country:US
Practice Address - Phone:914-834-2128
Practice Address - Fax:914-834-2128
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR035994-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical