Provider Demographics
NPI:1093473423
Name:GARBER, JULIET (LCSW-C)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:GARBER
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 1:7791 GEORGIAN BAY CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-5614
Mailing Address - Country:US
Mailing Address - Phone:267-625-1351
Mailing Address - Fax:
Practice Address - Street 1:7791 GEORGIAN BAY CIR APT 202
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-5614
Practice Address - Country:US
Practice Address - Phone:267-625-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28017104100000X
FLTPSW43511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical