Provider Demographics
NPI:1942358387
Name:SANDINE, JULIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:SANDINE
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 1:3050 11TH AVENUE DR SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-8336
Mailing Address - Country:US
Mailing Address - Phone:828-695-5900
Mailing Address - Fax:828-695-4256
Practice Address - Street 1:350 E PARKER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5155
Practice Address - Country:US
Practice Address - Phone:828-438-6226
Practice Address - Fax:828-438-6225
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0038811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCTAXID#OtherMEDCOST
NCTAXID#OtherTRICARE
NC6003186Medicaid
NCTAXID#OtherTRICARE