Provider Demographics
NPI:1275133407
Name:PATCHAN, JULIANNE GRACE (LCPC)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:GRACE
Last Name:PATCHAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9518 SWEET GRASS RDG
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2066
Mailing Address - Country:US
Mailing Address - Phone:240-593-8395
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 108
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6419
Practice Address - Country:US
Practice Address - Phone:240-296-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP108936101YM0800X
MDLC13078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health