Provider Demographics
NPI:1891199642
Name:EMMETT, JULIA (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:EMMETT
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 1:3711 REEDS LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-1370
Mailing Address - Country:US
Mailing Address - Phone:208-860-9840
Mailing Address - Fax:
Practice Address - Street 1:3711 REEDS LANDING CIR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-1370
Practice Address - Country:US
Practice Address - Phone:208-860-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040087231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical