Provider Demographics
NPI:1760536023
Name:VONDERHAAR, JULIE ELAYNE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELAYNE
Last Name:VONDERHAAR
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ANDOVER STREET
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1521
Mailing Address - Country:US
Mailing Address - Phone:978-595-7551
Mailing Address - Fax:978-745-7615
Practice Address - Street 1:23 ANDOVER STREET
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01996-1521
Practice Address - Country:US
Practice Address - Phone:978-595-7551
Practice Address - Fax:978-745-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health