Provider Demographics
NPI:1063629731
Name:BUFFINGTON, JULIE A (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BURD ST
Mailing Address - Street 2:RM 207
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:845-358-4787
Mailing Address - Fax:845-353-0548
Practice Address - Street 1:48 BURD ST
Practice Address - Street 2:RM 207
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960
Practice Address - Country:US
Practice Address - Phone:845-358-4787
Practice Address - Fax:845-353-0548
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0241381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical