Provider Demographics
NPI:1881658326
Name:WHITT, JULIE SMITH (LCSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:SMITH
Last Name:WHITT
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 GREEN VALLEY RD
Mailing Address - Street 2:SUITE310
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7042
Mailing Address - Country:US
Mailing Address - Phone:336-272-0855
Mailing Address - Fax:336-272-9885
Practice Address - Street 1:806 GREEN VALLEY RD
Practice Address - Street 2:SUITE310
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7042
Practice Address - Country:US
Practice Address - Phone:336-272-0855
Practice Address - Fax:336-272-9885
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0000621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2867571Medicare ID - Type Unspecified