Provider Demographics
NPI:1871682682
Name:WIEN, JULIE LYNN (LCSW, LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:WIEN
Suffix:
Gender:F
Credentials:LCSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ASPEN COURT
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648
Mailing Address - Country:US
Mailing Address - Phone:201-960-3563
Mailing Address - Fax:201-592-7222
Practice Address - Street 1:113 ASPEN COURT
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648
Practice Address - Country:US
Practice Address - Phone:201-960-3563
Practice Address - Fax:201-592-7222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044981-1104100000X
NJSC000045001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker