Provider Demographics
NPI:1750570529
Name:PINCHAK, JULIE A (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:PINCHAK
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 1:7329 11TH ST BLDG 547
Mailing Address - Street 2:75 MDOS/SGOHF
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5012
Mailing Address - Country:US
Mailing Address - Phone:801-777-3497
Mailing Address - Fax:801-586-4011
Practice Address - Street 1:7329 11TH ST BLDG 547
Practice Address - Street 2:75 MDOS/SGOHF
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-3497
Practice Address - Fax:801-586-4011
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical