Provider Demographics
NPI:1164857215
Name:O'LEARY, JULIANN M (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JULIANN
Middle Name:M
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 VETERANS MEMORIAL HWY STE 9
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4326
Mailing Address - Country:US
Mailing Address - Phone:631-888-5917
Mailing Address - Fax:
Practice Address - Street 1:358 VETERANS MEMORIAL HWY STE 9
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4326
Practice Address - Country:US
Practice Address - Phone:631-888-5917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005527-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005527-1OtherLMHC
NY268488OtherNCC