Provider Demographics
NPI:1326431909
Name:GREENBERG, JULIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 GREENE ST.
Mailing Address - Street 2:B202
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19119
Mailing Address - Country:US
Mailing Address - Phone:215-843-9592
Mailing Address - Fax:
Practice Address - Street 1:6445 GREENE ST.
Practice Address - Street 2:B202
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19119
Practice Address - Country:US
Practice Address - Phone:215-843-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000554106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist