Provider Demographics
NPI:1083153597
Name:ALLEN, JULIE OGLESBY (MA, LAPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:OGLESBY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MA, LAPC, NCC
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:OGLESBY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LAPC, NCC
Mailing Address - Street 1:1 S BROAD ST SW STE 5
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-4424
Mailing Address - Country:US
Mailing Address - Phone:706-314-8696
Mailing Address - Fax:
Practice Address - Street 1:1 S BROAD ST SW STE 5
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161
Practice Address - Country:US
Practice Address - Phone:706-314-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005673101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor