Provider Demographics
NPI:1578779468
Name:BERRETH, JULIA CLARE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CLARE
Last Name:BERRETH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3404
Mailing Address - Country:US
Mailing Address - Phone:360-993-0577
Mailing Address - Fax:
Practice Address - Street 1:601 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3404
Practice Address - Country:US
Practice Address - Phone:360-993-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60059981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist