Provider Demographics
NPI:1619075553
Name:ROCKWOOD, JULIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:ROCKWOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:ROCKWOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:210 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3004
Mailing Address - Country:US
Mailing Address - Phone:586-588-5241
Mailing Address - Fax:
Practice Address - Street 1:210 42ND ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3004
Practice Address - Country:US
Practice Address - Phone:586-588-5241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010782851041C0700X
CALCSW647031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801078285OtherDEPT OF COMMUNITY HEALTH