Provider Demographics
NPI:1588425144
Name:JULIUS, TRACEY A (LCSW)
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:A
Last Name:JULIUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:CIRILLO
Other - Last Name:JULIUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8732 CASTLEBAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1862
Mailing Address - Country:US
Mailing Address - Phone:704-307-1106
Mailing Address - Fax:
Practice Address - Street 1:8732 CASTLEBAY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-1862
Practice Address - Country:US
Practice Address - Phone:704-307-1106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0165681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical