Provider Demographics
NPI:1689781494
Name:PASTORIUS, JULIE ANNE (MSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:PASTORIUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 W LIBERTY AVE
Mailing Address - Street 2:1ST. FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-2526
Mailing Address - Country:US
Mailing Address - Phone:412-341-8326
Mailing Address - Fax:412-291-1098
Practice Address - Street 1:2944 W LIBERTY AVE
Practice Address - Street 2:1ST. FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2526
Practice Address - Country:US
Practice Address - Phone:412-341-8326
Practice Address - Fax:412-291-1098
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01914556Medicaid
PA01914556Medicaid