Provider Demographics
NPI:1326178336
Name:GUILFOYLE, JULIE PATRICIA (LISW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:PATRICIA
Last Name:GUILFOYLE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MELANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:10901 REED HARTMAN HWY
Mailing Address - Street 2:STE 111
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2847
Mailing Address - Country:US
Mailing Address - Phone:513-262-3409
Mailing Address - Fax:513-296-9251
Practice Address - Street 1:10901 REED HARTMAN HWY
Practice Address - Street 2:STE 111
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2847
Practice Address - Country:US
Practice Address - Phone:513-262-3409
Practice Address - Fax:513-297-9251
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00088411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW34931Medicare PIN