Provider Demographics
NPI:1851417174
Name:JULIAN, REBECCA A (LCSW-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:JULIAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 511
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-0511
Mailing Address - Country:US
Mailing Address - Phone:410-490-7357
Mailing Address - Fax:410-356-2513
Practice Address - Street 1:205 E WATER ST STE C
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1155
Practice Address - Country:US
Practice Address - Phone:410-490-7357
Practice Address - Fax:410-356-2513
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062551041C0700X
MD136381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413942900Medicaid
MD600195OtherVALUE OPTIONS
MDAX12-0001OtherCAREFIRST BCBS
MD2927813OtherCIGNA
MD522156095OtherCOMMERCIAL INSURANCE
MD742LOtherCAREFIRST BCBS
MD522156095OtherMHN