Provider Demographics
NPI:1831241231
Name:WARREN, JULIE L (CSC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:WARREN
Suffix:
Gender:F
Credentials:CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7454 W ADKINS AVE
Mailing Address - Street 2:
Mailing Address - City:WILLARDS
Mailing Address - State:MD
Mailing Address - Zip Code:21874-1242
Mailing Address - Country:US
Mailing Address - Phone:410-835-3364
Mailing Address - Fax:
Practice Address - Street 1:422 W MARKET ST
Practice Address - Street 2:WORCESTER COUNTY HEALTH DEPARTMENT - MARKET SQUARE
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-1127
Practice Address - Country:US
Practice Address - Phone:410-632-4510
Practice Address - Fax:410-632-4933
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC0422101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS013Medicare ID - Type Unspecified