Provider Demographics
NPI:1639828163
Name:ERDMAN, JULIE BURROUGHS (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:BURROUGHS
Last Name:ERDMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-4460
Mailing Address - Country:US
Mailing Address - Phone:845-745-0921
Mailing Address - Fax:631-320-2236
Practice Address - Street 1:82 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4460
Practice Address - Country:US
Practice Address - Phone:845-745-0921
Practice Address - Fax:631-320-2236
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113804104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker