Provider Demographics
NPI:1689738213
Name:MUELLER, JULIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2642 CENTRAL DR
Mailing Address - Street 2:1N
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1138
Mailing Address - Country:US
Mailing Address - Phone:312-246-0465
Mailing Address - Fax:708-647-1274
Practice Address - Street 1:16860 OAK PARK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2761
Practice Address - Country:US
Practice Address - Phone:312-246-0465
Practice Address - Fax:708-647-1274
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002743101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180002743OtherLICENSE NUMBER
IL180002743OtherLICENSE NUMBER