Provider Demographics
NPI:1174602098
Name:FENDER, JULIE (LPCC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FENDER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7577 CENTRAL PARKE BLVD STE 219
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6806
Mailing Address - Country:US
Mailing Address - Phone:513-236-4222
Mailing Address - Fax:513-336-7299
Practice Address - Street 1:7577 CENTRAL PARKE BLVD STE219
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-236-4222
Practice Address - Fax:513-336-7299
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health