Provider Demographics
NPI:1831961101
Name:DIMATTEO, JULIA C (MHB, LMSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:DIMATTEO
Suffix:
Gender:F
Credentials:MHB, LMSW
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:JACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 ONIX DR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1886
Mailing Address - Country:US
Mailing Address - Phone:484-731-2496
Mailing Address - Fax:
Practice Address - Street 1:263 QUIGLEY BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:HISTORIC NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8112
Practice Address - Country:US
Practice Address - Phone:302-323-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010973104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker