Provider Demographics
NPI:1700120094
Name:SMITH, JULIA MARIE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:MARIE
Last Name:SMITH
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 1:102 PRESTON PINES DR
Mailing Address - Street 2:C-100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3493
Mailing Address - Country:US
Mailing Address - Phone:919-357-7743
Mailing Address - Fax:
Practice Address - Street 1:1145 EXECUTIVE CIR STE D
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4586
Practice Address - Country:US
Practice Address - Phone:919-514-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0074121041C0700X
NCC0090241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical