Provider Demographics
NPI:1679117550
Name:CANTONE, JULIA S (LCSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:S
Last Name:CANTONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:S
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5718 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1008
Mailing Address - Country:US
Mailing Address - Phone:703-965-4403
Mailing Address - Fax:
Practice Address - Street 1:324 N FAIRFAX ST STE 200
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2625
Practice Address - Country:US
Practice Address - Phone:703-261-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040112961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical