Provider Demographics
NPI:1326442435
Name:DEERING, JULIA ROSE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ROSE
Last Name:DEERING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ROSE
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:328 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-3794
Mailing Address - Country:US
Mailing Address - Phone:508-765-9101
Mailing Address - Fax:
Practice Address - Street 1:328 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-3794
Practice Address - Country:US
Practice Address - Phone:508-765-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002225461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical