Provider Demographics
NPI:1194063685
Name:FRASCIELLO, JULIA ANNUNZIATINA (LSW)
Entity type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:ANNUNZIATINA
Last Name:FRASCIELLO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6473
Mailing Address - Country:US
Mailing Address - Phone:201-669-8733
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST LOWR
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1142
Practice Address - Country:US
Practice Address - Phone:732-727-2555
Practice Address - Fax:732-727-0255
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05814300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)