Provider Demographics
NPI:1437335528
Name:SICKLES, JULIA K (LCSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:SICKLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 W 12600 S STE 110
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7270
Mailing Address - Country:US
Mailing Address - Phone:269-932-5330
Mailing Address - Fax:
Practice Address - Street 1:3409 W 12600 S STE 110
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7270
Practice Address - Country:US
Practice Address - Phone:435-248-2325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010865291041C0700X
GACSW 0046241041C0700X
UT9452890-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical