Provider Demographics
NPI:1114268877
Name:JULIE ASEN PHD LCSW LLC
Entity Type:Organization
Organization Name:JULIE ASEN PHD LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:561-706-9060
Mailing Address - Street 1:621 NW 53RD ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8235
Mailing Address - Country:US
Mailing Address - Phone:561-706-9060
Mailing Address - Fax:
Practice Address - Street 1:621 NW 53RD ST
Practice Address - Street 2:SUITE 240
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-8235
Practice Address - Country:US
Practice Address - Phone:561-706-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3219OtherMEDICARE