Provider Demographics
NPI:1326645359
Name:CAPSHAW, JULLEE LORRAINE (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:JULLEE
Middle Name:LORRAINE
Last Name:CAPSHAW
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LORRAINE
Other - Last Name:CAPSHAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC-A
Mailing Address - Street 1:4724 KEENELAND LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-5770
Mailing Address - Country:US
Mailing Address - Phone:678-907-3400
Mailing Address - Fax:
Practice Address - Street 1:20501 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8460
Practice Address - Country:US
Practice Address - Phone:704-912-4095
Practice Address - Fax:704-943-0512
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19062101YM0800X
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health