Provider Demographics
NPI:1902281967
Name:HAROVER, JULIA ALDEN
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ALDEN
Last Name:HAROVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALDEN
Other - Middle Name:WATSON
Other - Last Name:HAROVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1351 NEWTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511
Mailing Address - Country:US
Mailing Address - Phone:859-272-7483
Mailing Address - Fax:859-254-3376
Practice Address - Street 1:1351 NEWTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511
Practice Address - Country:US
Practice Address - Phone:859-272-7483
Practice Address - Fax:859-254-3376
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
KY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1790731081Medicaid