Provider Demographics
NPI:1760003396
Name:GREENBERG, JULIA ROSE (LMHC-T)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:LMHC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-2952
Mailing Address - Country:US
Mailing Address - Phone:631-835-0748
Mailing Address - Fax:
Practice Address - Street 1:364 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAG HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11963-2952
Practice Address - Country:US
Practice Address - Phone:631-835-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health