Provider Demographics
NPI:1467290205
Name:CARRION, JULIANA C (LSW)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:C
Last Name:CARRION
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 1:3215 W CRYSTAL ST BSMT FRONT
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-2474
Mailing Address - Country:US
Mailing Address - Phone:312-810-7856
Mailing Address - Fax:
Practice Address - Street 1:3215 W CRYSTAL ST BSMT FRONT
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-2474
Practice Address - Country:US
Practice Address - Phone:312-810-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1119971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical