Provider Demographics
NPI:1619154044
Name:SPEARS, JULIE LATIMER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LATIMER
Last Name:SPEARS
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 1:10000 CRATER LAKE PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-2693
Mailing Address - Country:US
Mailing Address - Phone:512-497-4782
Mailing Address - Fax:
Practice Address - Street 1:4422 PACK SADDLE PASS
Practice Address - Street 2:SUITE 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1681
Practice Address - Country:US
Practice Address - Phone:512-497-4782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical