Provider Demographics
NPI:1679252852
Name:PETER, JULIE ALLISON (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ALLISON
Last Name:PETER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:ALLISON
Other - Last Name:PETER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:150 WHITE PLAINS RD STE 208
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5521
Mailing Address - Country:US
Mailing Address - Phone:845-419-8473
Mailing Address - Fax:888-325-0080
Practice Address - Street 1:150 WHITE PLAINS RD STE 208
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5521
Practice Address - Country:US
Practice Address - Phone:845-419-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120381104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty