Provider Demographics
NPI:1790367332
Name:LOUIS, JULIENNE (MS, NCC, LMFT)
Entity Type:Individual
Prefix:
First Name:JULIENNE
Middle Name:
Last Name:LOUIS
Suffix:
Gender:F
Credentials:MS, NCC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 NW 18TH DR APT 204
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-5991
Mailing Address - Country:US
Mailing Address - Phone:561-695-6155
Mailing Address - Fax:
Practice Address - Street 1:9900 W SAMPLE RD # 339
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4048
Practice Address - Country:US
Practice Address - Phone:561-740-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IMT3310106H00000X
FLMT4666106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist