Provider Demographics
NPI:1245884550
Name:SIMMONS, JULIA STEPHANIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:STEPHANIE
Last Name:SIMMONS
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 1:45 E PUTNAM AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5408
Mailing Address - Country:US
Mailing Address - Phone:203-247-6362
Mailing Address - Fax:
Practice Address - Street 1:45 E PUTNAM AVE STE 108
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5408
Practice Address - Country:US
Practice Address - Phone:203-247-6362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT107871041C0700X
NY0881681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical