Provider Demographics
NPI:1114794690
Name:SMITH, JULIE GAY (MSSW, LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:GAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 RUFE SNOW DR STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6686
Mailing Address - Country:US
Mailing Address - Phone:817-576-2447
Mailing Address - Fax:844-273-0993
Practice Address - Street 1:5424 RUFE SNOW DR STE 304
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6686
Practice Address - Country:US
Practice Address - Phone:817-576-2447
Practice Address - Fax:844-273-0993
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64638104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker