Provider Demographics
NPI:1104674951
Name:SEWELL, JULIA BROOKS
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:BROOKS
Last Name:SEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 SURRY DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-7140
Mailing Address - Country:US
Mailing Address - Phone:704-692-5729
Mailing Address - Fax:
Practice Address - Street 1:809 N LAFAYETTE ST STE A
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3886
Practice Address - Country:US
Practice Address - Phone:704-278-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0204441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical