Provider Demographics
NPI:1376708354
Name:VOGEL, JULIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:VOGEL
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 1:1671 BRANDYWINE RD APT 2112
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2082
Mailing Address - Country:US
Mailing Address - Phone:931-237-0583
Mailing Address - Fax:571-282-6422
Practice Address - Street 1:1671 BRANDYWINE RD.
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:931-237-0583
Practice Address - Fax:571-282-6422
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22575101YM0800X
TN2045101YM0800X
VA0701007891101YP2500X, 101YM0800X
TN0000002045101YP2500X
FL22575101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376708354Medicaid
TN1522670Medicaid
VA30017578340001Medicaid