Provider Demographics
NPI:1376068189
Name:LOVE-RICHARDSON, JULIE-ANN KIRSTEN (LPC)
Entity Type:Individual
Prefix:
First Name:JULIE-ANN
Middle Name:KIRSTEN
Last Name:LOVE-RICHARDSON
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 1:23737 N ELM RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2201
Mailing Address - Country:US
Mailing Address - Phone:609-369-6879
Mailing Address - Fax:
Practice Address - Street 1:23737 N ELM RD
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2201
Practice Address - Country:US
Practice Address - Phone:609-369-6879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health