Provider Demographics
NPI:1083298905
Name:DIGENOVA, JULIA AMANDA (LSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:AMANDA
Last Name:DIGENOVA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4240
Mailing Address - Country:US
Mailing Address - Phone:330-340-6615
Mailing Address - Fax:
Practice Address - Street 1:2406 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4240
Practice Address - Country:US
Practice Address - Phone:330-340-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1904031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker