Provider Demographics
NPI:1124576335
Name:ROY, JULIA LANTZ (MA, LPC-S, CART)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LANTZ
Last Name:ROY
Suffix:
Gender:F
Credentials:MA, LPC-S, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 CLEPPER
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-3129
Mailing Address - Country:US
Mailing Address - Phone:936-597-7055
Mailing Address - Fax:
Practice Address - Street 1:780 CLEPPER
Practice Address - Street 2:SUITE 203
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-3129
Practice Address - Country:US
Practice Address - Phone:936-597-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65412101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional