Provider Demographics
NPI:1639237639
Name:ASEN, JULIE ROBIN (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ROBIN
Last Name:ASEN
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 NW 53RD ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8235
Mailing Address - Country:US
Mailing Address - Phone:561-706-9060
Mailing Address - Fax:
Practice Address - Street 1:621 NW 53RD ST
Practice Address - Street 2:SUITE 240
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-8235
Practice Address - Country:US
Practice Address - Phone:561-706-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-00045421041C0700X
NV5020-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE3219Medicare ID - Type Unspecified