Provider Demographics
NPI:1306925060
Name:FREY, JULIE ANN (LICSW LLC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:FREY
Suffix:
Gender:F
Credentials:LICSW LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 COMMONWEALTH AVE
Mailing Address - Street 2:APT 14
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2119
Mailing Address - Country:US
Mailing Address - Phone:857-500-9902
Mailing Address - Fax:
Practice Address - Street 1:358 COMMONWEALTH AVE
Practice Address - Street 2:APT 14
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2119
Practice Address - Country:US
Practice Address - Phone:857-500-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical