Provider Demographics
NPI:1700363934
Name:MCNAMARA, JULIA (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MCNAMARA
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 1:64 HILLSIDE AVE APT 4DD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4806
Mailing Address - Country:US
Mailing Address - Phone:646-489-6419
Mailing Address - Fax:
Practice Address - Street 1:64 HILLSIDE AVE APT 4DD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4806
Practice Address - Country:US
Practice Address - Phone:646-489-6419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104074-1104100000X
NY1041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical