Provider Demographics
NPI:1316129380
Name:PARADIS, JULIE ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELIZABETH
Last Name:PARADIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-2906
Mailing Address - Country:US
Mailing Address - Phone:413-568-3942
Mailing Address - Fax:413-568-5983
Practice Address - Street 1:91 ELM ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-2906
Practice Address - Country:US
Practice Address - Phone:413-568-3942
Practice Address - Fax:413-568-5983
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical