Provider Demographics
NPI:1013329804
Name:SCHULMAN, JULIE ANNE
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:SCHULMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:SCHULMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:325 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-2611
Mailing Address - Country:US
Mailing Address - Phone:585-325-5100
Mailing Address - Fax:585-325-5154
Practice Address - Street 1:325 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-2611
Practice Address - Country:US
Practice Address - Phone:585-325-5100
Practice Address - Fax:585-325-5154
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035833101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1073614533Medicaid