Provider Demographics
NPI:1588082770
Name:MITCHELL, JULIA ANN (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:609 S SHARP ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3621
Mailing Address - Country:US
Mailing Address - Phone:443-557-8725
Mailing Address - Fax:410-800-2875
Practice Address - Street 1:145 W OSTEND ST STE 618
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3764
Practice Address - Country:US
Practice Address - Phone:443-872-5725
Practice Address - Fax:410-780-0364
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD173091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD422975400Medicaid