Provider Demographics
NPI:1417402553
Name:SANFORD, JULIA GRAY (LICSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GRAY
Last Name:SANFORD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3401
Mailing Address - Country:US
Mailing Address - Phone:205-838-3349
Mailing Address - Fax:205-838-3451
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 159
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-3349
Practice Address - Fax:205-838-3451
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3405G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker