Provider Demographics
NPI:1407983091
Name:MCDERMOTT, JULIE ANN (MS, PLMHP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3869 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1806
Mailing Address - Country:US
Mailing Address - Phone:402-203-9118
Mailing Address - Fax:
Practice Address - Street 1:3869 CALIFORNIA STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1806
Practice Address - Country:US
Practice Address - Phone:402-203-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health