Provider Demographics
NPI:1538351002
Name:BURSTYN, JULIE SUE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SUE
Last Name:BURSTYN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:SUE
Other - Last Name:BURSTYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:15490 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6250
Mailing Address - Country:US
Mailing Address - Phone:305-685-0381
Mailing Address - Fax:305-685-7536
Practice Address - Street 1:15490 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6250
Practice Address - Country:US
Practice Address - Phone:305-685-0381
Practice Address - Fax:305-685-6976
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW57071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical