Provider Demographics
NPI:1326310301
Name:GOODOWENS, JULIA W (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:W
Last Name:GOODOWENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6732
Mailing Address - Country:US
Mailing Address - Phone:423-316-5409
Mailing Address - Fax:423-510-1888
Practice Address - Street 1:101 JORDAN DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6732
Practice Address - Country:US
Practice Address - Phone:423-316-5409
Practice Address - Fax:423-510-1888
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0012331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical