Provider Demographics
NPI:1316032964
Name:LONSTEIN, JULIE S (PHD ABD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:S
Last Name:LONSTEIN
Suffix:
Gender:F
Credentials:PHD ABD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CAMP WOODS LANE
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428
Mailing Address - Country:US
Mailing Address - Phone:845-647-1750
Mailing Address - Fax:845-647-6277
Practice Address - Street 1:1 TERRACE HILL
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428
Practice Address - Country:US
Practice Address - Phone:845-647-1750
Practice Address - Fax:845-647-6277
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000494-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health