Provider Demographics
NPI:1255895447
Name:ZIV, JULIA WRIGHT (LCSW, MS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:WRIGHT
Last Name:ZIV
Suffix:
Gender:F
Credentials:LCSW, MS
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:JENNINGS
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1156 W NEWPORT AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1513
Mailing Address - Country:US
Mailing Address - Phone:312-919-4202
Mailing Address - Fax:
Practice Address - Street 1:1156 W NEWPORT AVE # 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1513
Practice Address - Country:US
Practice Address - Phone:312-919-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0207211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty