Provider Demographics
NPI:1063143089
Name:BURNS, JULIE (PHD, LMSW)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 KIRK DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-3524
Mailing Address - Country:US
Mailing Address - Phone:585-485-9295
Mailing Address - Fax:
Practice Address - Street 1:7706 13TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2414
Practice Address - Country:US
Practice Address - Phone:917-588-1246
Practice Address - Fax:718-228-9314
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068964104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker