Provider Demographics
NPI:1558013433
Name:TALCOTT, JULIE K (LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:TALCOTT
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 1:701 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-9186
Mailing Address - Country:US
Mailing Address - Phone:940-577-6304
Mailing Address - Fax:
Practice Address - Street 1:701 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-9186
Practice Address - Country:US
Practice Address - Phone:940-577-6304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional