Provider Demographics
NPI:1932830494
Name:DESOUSA, JULIETTE-MARIE (MA, MSW, LGSW)
Entity Type:Individual
Prefix:MS
First Name:JULIETTE-MARIE
Middle Name:
Last Name:DESOUSA
Suffix:
Gender:F
Credentials:MA, MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3883 CONNECTICUT AVE NW APT 510
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4576
Mailing Address - Country:US
Mailing Address - Phone:202-686-9268
Mailing Address - Fax:
Practice Address - Street 1:1616 18TH ST NW APT 206
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2525
Practice Address - Country:US
Practice Address - Phone:202-232-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500835831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical