Provider Demographics
NPI:1700958170
Name:CATALANO, JULIE ANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:CATALANO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 HIGHLAND AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144
Mailing Address - Country:US
Mailing Address - Phone:617-776-0184
Mailing Address - Fax:617-666-2720
Practice Address - Street 1:403 HIGHLAND AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144
Practice Address - Country:US
Practice Address - Phone:617-666-2720
Practice Address - Fax:617-666-2720
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1030757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1858025Medicaid
P21374Medicare ID - Type Unspecified