Provider Demographics
NPI:1558675603
Name:WELLS, JULIE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:WELLS
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:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34681-0464
Mailing Address - Country:US
Mailing Address - Phone:727-688-5800
Mailing Address - Fax:727-286-9640
Practice Address - Street 1:26133 US HIGHWAY 19 N STE 310
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-2017
Practice Address - Country:US
Practice Address - Phone:727-688-5800
Practice Address - Fax:727-286-9640
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-31
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW99661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical