Provider Demographics
NPI:1710613138
Name:FINEFROCK, JULIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FINEFROCK
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 1:90 PIERMONT PL
Mailing Address - Street 2:
Mailing Address - City:PIERMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10968-1127
Mailing Address - Country:US
Mailing Address - Phone:917-531-1420
Mailing Address - Fax:
Practice Address - Street 1:1 PIERMONT AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3208
Practice Address - Country:US
Practice Address - Phone:917-531-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110072104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker