Provider Demographics
NPI:1982747895
Name:DYSON, JULIE GAY (MSW LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:GAY
Last Name:DYSON
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:GAY
Other - Last Name:LITVAG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:10950 SCHUETZ RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5704
Mailing Address - Country:US
Mailing Address - Phone:314-993-1000
Mailing Address - Fax:314-812-9398
Practice Address - Street 1:10950 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5704
Practice Address - Country:US
Practice Address - Phone:314-993-1000
Practice Address - Fax:314-812-9398
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0057371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical