Provider Demographics
NPI:1518051044
Name:PHIFER, JULEE K (LCSW)
Entity type:Individual
Prefix:MS
First Name:JULEE
Middle Name:K
Last Name:PHIFER
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 1:400 CHERRY STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030
Mailing Address - Country:US
Mailing Address - Phone:336-429-8232
Mailing Address - Fax:336-786-4408
Practice Address - Street 1:849 EAST PINE STREET
Practice Address - Street 2:MOUNT AIRY
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030
Practice Address - Country:US
Practice Address - Phone:336-789-4408
Practice Address - Fax:336-786-4408
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0011251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003755Medicaid
NC2869560EMedicare ID - Type Unspecified