Provider Demographics
NPI:1558877209
Name:MINEROVIC, JULIA ROSE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ROSE
Last Name:MINEROVIC
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 1:6914 WAKEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3956
Mailing Address - Country:US
Mailing Address - Phone:330-554-5460
Mailing Address - Fax:
Practice Address - Street 1:4199 MILLPOND DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND HILLS
Practice Address - State:OH
Practice Address - Zip Code:44122-5731
Practice Address - Country:US
Practice Address - Phone:216-302-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1600002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional