Provider Demographics
NPI:1114279684
Name:STONEHAM, JULIE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LOUISE
Last Name:STONEHAM
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 1:15230 SE 105TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-4618
Mailing Address - Country:US
Mailing Address - Phone:919-946-0143
Mailing Address - Fax:
Practice Address - Street 1:13940 N US HIGHWAY 441 STE 210
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8909
Practice Address - Country:US
Practice Address - Phone:352-374-3222
Practice Address - Fax:352-268-1168
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW144481041C0700X
FLSW14481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical