Provider Demographics
NPI:1063684645
Name:NISE, JULIE M (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:NISE
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PECAN DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3828
Mailing Address - Country:US
Mailing Address - Phone:281-996-6888
Mailing Address - Fax:281-996-6889
Practice Address - Street 1:106 PECAN DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3828
Practice Address - Country:US
Practice Address - Phone:281-996-6888
Practice Address - Fax:281-996-6889
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18894101YM0800X
TX5025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist