Provider Demographics
NPI:1467994921
Name:LUNDY, JULIE (EDS, NBCC, LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LUNDY
Suffix:
Gender:F
Credentials:EDS, NBCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6442
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29260-6442
Mailing Address - Country:US
Mailing Address - Phone:803-931-0878
Mailing Address - Fax:
Practice Address - Street 1:4500 FORT JACKSON BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1134
Practice Address - Country:US
Practice Address - Phone:803-931-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6093101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor