Provider Demographics
NPI:1053052712
Name:YEN, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:YEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 NORCROSS WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2966
Mailing Address - Country:US
Mailing Address - Phone:240-281-1998
Mailing Address - Fax:
Practice Address - Street 1:9701 PHILADELPHIA CT STE M
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4400
Practice Address - Country:US
Practice Address - Phone:301-210-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD315481041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool