Provider Demographics
NPI:1669855359
Name:CORLEY, JULIA KATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:KATHERINE
Last Name:CORLEY
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 1:3010 SCOTT BLVD
Mailing Address - Street 2:STE. 103
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6800
Mailing Address - Country:US
Mailing Address - Phone:254-773-4022
Mailing Address - Fax:
Practice Address - Street 1:9015 MOUNTAIN RIDGE DR
Practice Address - Street 2:HOUSTON BLDG, STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7370
Practice Address - Country:US
Practice Address - Phone:512-201-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73387101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional