Provider Demographics
NPI:1598146656
Name:WHITFORD, JULIE A (LPCC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:WHITFORD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 10TH ST N STE 310A
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6166
Mailing Address - Country:US
Mailing Address - Phone:651-983-2591
Mailing Address - Fax:651-305-0427
Practice Address - Street 1:6230 10TH ST N STE 310A
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6166
Practice Address - Country:US
Practice Address - Phone:651-983-2591
Practice Address - Fax:651-305-0427
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health