Provider Demographics
NPI:1619960374
Name:STAHL, JULIA THERESA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:THERESA
Last Name:STAHL
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 1:305 ROSEBERRY STREET
Mailing Address - Street 2:STE 9
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865
Mailing Address - Country:US
Mailing Address - Phone:908-619-7334
Mailing Address - Fax:908-387-4275
Practice Address - Street 1:305 ROSEBERRY STREET
Practice Address - Street 2:STE 9
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865
Practice Address - Country:US
Practice Address - Phone:908-619-7334
Practice Address - Fax:908-387-4275
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0212091041C0700X
DEQ1-00118831041C0700X
NJ44SC045459001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
171994000OtherMAGELLAN
ST895798Medicare ID - Type Unspecified