Provider Demographics
NPI:1881021129
Name:SORRELL, JULIE ALLISON (MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ALLISON
Last Name:SORRELL
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WEST GRAND STREET
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202
Mailing Address - Country:US
Mailing Address - Phone:908-354-3040
Mailing Address - Fax:908-354-2665
Practice Address - Street 1:80 WEST GRAND STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202
Practice Address - Country:US
Practice Address - Phone:908-354-3040
Practice Address - Fax:908-354-2665
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05627800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker