Provider Demographics
NPI:1336912674
Name:CARDELLO, JULIE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:CARDELLO
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 1:405 N HALIFAX AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-4001
Mailing Address - Country:US
Mailing Address - Phone:412-977-5412
Mailing Address - Fax:
Practice Address - Street 1:405 N HALIFAX AVE APT 106
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-4001
Practice Address - Country:US
Practice Address - Phone:412-977-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW222431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical