Provider Demographics
NPI:1104021393
Name:SUTTLE III, JULIUS ALBERT (LPC)
Entity Type:Individual
Prefix:MR
First Name:JULIUS
Middle Name:ALBERT
Last Name:SUTTLE III
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:JULIUS
Other - Middle Name:BERT
Other - Last Name:SUTTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:39 FIELDCREST RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9423
Mailing Address - Country:US
Mailing Address - Phone:828-778-0343
Mailing Address - Fax:828-684-0772
Practice Address - Street 1:39 FIELDCREST RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9423
Practice Address - Country:US
Practice Address - Phone:828-778-0343
Practice Address - Fax:828-684-0772
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102938Medicaid