Provider Demographics
NPI:1659020261
Name:ROTHERMICH, JULIA CHRISTINE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:CHRISTINE
Last Name:ROTHERMICH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MEXICO RD
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-2805
Mailing Address - Country:US
Mailing Address - Phone:636-248-1911
Mailing Address - Fax:
Practice Address - Street 1:13422 CLAYTON RD STE 202
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1008
Practice Address - Country:US
Practice Address - Phone:636-248-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional