Provider Demographics
NPI:1841209814
Name:DEJULIO, STEVEN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:DEJULIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8996 BURKE LAKE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015
Mailing Address - Country:US
Mailing Address - Phone:703-978-6800
Mailing Address - Fax:703-978-6801
Practice Address - Street 1:8996 BURKE LAKE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015
Practice Address - Country:US
Practice Address - Phone:703-978-6800
Practice Address - Fax:703-978-6801
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1490103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00709013Medicaid
VA00709013Medicaid