Provider Demographics
NPI:1689960858
Name:HOGAN, JULIA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 BROADWAY STE 314C
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5233
Mailing Address - Country:US
Mailing Address - Phone:720-334-7110
Mailing Address - Fax:
Practice Address - Street 1:636 COFFMAN ST STE 203
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4974
Practice Address - Country:US
Practice Address - Phone:720-334-7110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-25
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099235631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical