Provider Demographics
NPI:1366057028
Name:IPSAN, JULIEANN (LCSW-C)
Entity type:Individual
Prefix:
First Name:JULIEANN
Middle Name:
Last Name:IPSAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:JULIEANN
Other - Middle Name:
Other - Last Name:IPSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 THAMES DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-1151
Mailing Address - Country:US
Mailing Address - Phone:202-468-7817
Mailing Address - Fax:
Practice Address - Street 1:97 THOMAS JOHNSON DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-695-6455
Practice Address - Fax:301-695-6456
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical