Provider Demographics
NPI:1437464435
Name:MATHERS, JULIE PAIGE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:PAIGE
Last Name:MATHERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MATHERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2711 BUFORD RD UNIT 114
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2423
Mailing Address - Country:US
Mailing Address - Phone:336-303-2606
Mailing Address - Fax:855-292-8003
Practice Address - Street 1:10511 DURYEA DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-2104
Practice Address - Country:US
Practice Address - Phone:336-303-2606
Practice Address - Fax:855-292-8003
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040079681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical