Active NPI
Gwen W Julia, PHD
- Clinical Psychologist
- West Newton, MA
National Provider Identifier
1568594463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1091
- Practice address
- 60 Temple St
West Newton, MA 02465-2307 - Phone
- (617) 965-2956
- Fax
- (617) 244-8363
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1091 | MA | Primary |
Addresses
Primary practice location
60 Temple St
West Newton, MA 02465-2307
Mailing address
60 Temple St
West Newton, MA 02465-2307
Phone (617) 965-2956
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14174 | Other | NATL REG OF HLTH PROV PSY |
Other names 1
- Gwen Woodiwiss Julia
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1091 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568594463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 TEMPLE ST",
"city": "WEST NEWTON",
"state": "MA",
"postal_code": "024652307",
"telephone_number": "617-965-2956",
"fax_number": "617-244-8363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 TEMPLE ST",
"city": "WEST NEWTON",
"state": "MA",
"postal_code": "024652307",
"telephone_number": "617-965-2956",
"fax_number": "617-244-8363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JULIA",
"first_name": "GWEN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "1091",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATL REG OF HLTH PROV PSY",
"identifier": "14174",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GWEN",
"last_name": "JULIA",
"middle_name": "WOODIWISS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in West Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.