Provider Demographics
NPI:1912770439
Name:HANESSIAN, JULIA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:HANESSIAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10214
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20914-0214
Mailing Address - Country:US
Mailing Address - Phone:240-919-4871
Mailing Address - Fax:
Practice Address - Street 1:2334 STARCREST DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5402
Practice Address - Country:US
Practice Address - Phone:240-919-4871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD210991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty