Provider Demographics
NPI:1144783549
Name:SPIVEY, JULIA C (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:C
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 S VIENNA ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-6428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 S VIENNA ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-6428
Practice Address - Country:US
Practice Address - Phone:318-224-9200
Practice Address - Fax:318-224-9201
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2023-08-16
Deactivation Date:2020-10-16
Deactivation Code:
Reactivation Date:2023-08-16
Provider Licenses
StateLicense IDTaxonomies
LA51021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical