Provider Demographics
NPI:1265667927
Name:LEBOUITZ, JULIANE (MSW/LCSW)
Entity Type:Individual
Prefix:
First Name:JULIANE
Middle Name:
Last Name:LEBOUITZ
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6133
Mailing Address - Country:US
Mailing Address - Phone:412-613-2708
Mailing Address - Fax:
Practice Address - Street 1:2456 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8900
Practice Address - Country:US
Practice Address - Phone:484-821-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013661101Y00000X, 101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)