Provider Demographics
NPI:1316229263
Name:NICHOLSON, JULIE ANA (MSW, MPA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANA
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 CLINTON AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3415
Mailing Address - Country:US
Mailing Address - Phone:443-996-3915
Mailing Address - Fax:708-202-3650
Practice Address - Street 1:339 CLINTON AVE APT 9
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-3415
Practice Address - Country:US
Practice Address - Phone:443-996-3915
Practice Address - Fax:708-202-3650
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker