Provider Demographics
NPI:1063854834
Name:JULIE B. OJALVO, LCSW, PA
Entity type:Organization
Organization Name:JULIE B. OJALVO, LCSW, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:BENREY
Authorized Official - Last Name:OJALVO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-705-0606
Mailing Address - Street 1:20822 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1147
Mailing Address - Country:US
Mailing Address - Phone:305-705-0606
Mailing Address - Fax:305-705-0605
Practice Address - Street 1:20822 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1147
Practice Address - Country:US
Practice Address - Phone:305-705-0606
Practice Address - Fax:305-705-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5934261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health