Provider Demographics
NPI:1568018133
Name:JULIE MERGL, INC.
Entity Type:Organization
Organization Name:JULIE MERGL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MERGL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-466-1253
Mailing Address - Street 1:3895 TAR KILN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2097
Mailing Address - Country:US
Mailing Address - Phone:904-366-9617
Mailing Address - Fax:904-886-4017
Practice Address - Street 1:6100 GREENLAND RD STE 302
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2626
Practice Address - Country:US
Practice Address - Phone:904-366-9617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-10
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1427299320OtherNPI