Provider Demographics
NPI:1194470963
Name:DAVIDSON, JULIETA (LPC)
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 LAKES AT 610 DR APT 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2842
Mailing Address - Country:US
Mailing Address - Phone:832-518-0489
Mailing Address - Fax:
Practice Address - Street 1:11811 NORTH FWY STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3244
Practice Address - Country:US
Practice Address - Phone:346-336-1639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83262101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health