Provider Demographics
NPI:1619016821
Name:CULLEN, JULIE BETH (LICSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BETH
Last Name:CULLEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:BETH
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4865
Mailing Address - Country:US
Mailing Address - Phone:978-337-9888
Mailing Address - Fax:
Practice Address - Street 1:68 PARK ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3693
Practice Address - Country:US
Practice Address - Phone:978-337-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical