Provider Demographics
NPI:1790102473
Name:FIERLE, JULIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:FIERLE
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 1:3140 RANSOMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RANSOMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14131-9653
Mailing Address - Country:US
Mailing Address - Phone:716-359-6386
Mailing Address - Fax:
Practice Address - Street 1:6395 OLD NIAGARA RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-1421
Practice Address - Country:US
Practice Address - Phone:716-359-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0727991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical