Provider Demographics
NPI:1114674553
Name:FURNISS-GREEN, JULIANNE C (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:C
Last Name:FURNISS-GREEN
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 1:45 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6401
Mailing Address - Country:US
Mailing Address - Phone:631-838-8477
Mailing Address - Fax:
Practice Address - Street 1:45 CHARLES ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6401
Practice Address - Country:US
Practice Address - Phone:631-838-8477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0118261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical