Provider Demographics
NPI:1710922760
Name:STAUB, JULIE A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:STAUB
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2710
Mailing Address - Fax:717-339-2711
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:STE 202
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1926
Practice Address - Country:US
Practice Address - Phone:717-339-2710
Practice Address - Fax:717-339-2711
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW007424L104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA687124OtherBC/BS OF MD CARE FIRST
PA274558OtherMAMSI
PA01109601OtherCAPITAL BLUE CROSS
PA230725000OtherMAGELLAN
PA734554OtherPABS (FEP ONLY)
PA800009090OtherMEDICARE RAILROAD
PA129586OtherVALUE OPTIONS
PA2022462OtherCIGNA BEHAVIORAL HEALTH
PA687124OtherBC/BS OF MD CARE FIRST
PA01109601OtherCAPITAL BLUE CROSS