Provider Demographics
NPI:1003140740
Name:YORK, JULIE KRISTEN RANDALL (LCPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KRISTEN RANDALL
Last Name:YORK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KRISTEN
Other - Last Name:RANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:167 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-4747
Mailing Address - Country:US
Mailing Address - Phone:207-299-6052
Mailing Address - Fax:
Practice Address - Street 1:5 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-4823
Practice Address - Country:US
Practice Address - Phone:207-873-2136
Practice Address - Fax:207-660-4529
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC5237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional