Provider Demographics
NPI:1740397256
Name:EDWARDS, JULIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WEST 86 STR
Mailing Address - Street 2:APT PHT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3351
Mailing Address - Country:US
Mailing Address - Phone:212-595-0517
Mailing Address - Fax:212-579-2280
Practice Address - Street 1:27 W 86TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3615
Practice Address - Country:US
Practice Address - Phone:212-873-8832
Practice Address - Fax:212-579-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07048411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11520812OtherCAQH
NYP3649671OtherOXFORD
NY11520812OtherCAQH