Provider Demographics
NPI:1518120419
Name:LIEFELD, JULIE ANN (RN, PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:LIEFELD
Suffix:
Gender:F
Credentials:RN, PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 GOLD STAR HWY
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6221
Mailing Address - Country:US
Mailing Address - Phone:860-449-0200
Mailing Address - Fax:860-449-1959
Practice Address - Street 1:616 GOLD STAR HWY
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6221
Practice Address - Country:US
Practice Address - Phone:860-449-0200
Practice Address - Fax:860-449-1959
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist