Provider Demographics
NPI:1790397867
Name:LAURENT, JULIA L (BS, QMHP, CSAC-A)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:L
Last Name:LAURENT
Suffix:
Gender:F
Credentials:BS, QMHP, CSAC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 STONEWALL ST
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22657-6311
Mailing Address - Country:US
Mailing Address - Phone:540-481-4794
Mailing Address - Fax:
Practice Address - Street 1:500 PEGASUS CT
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4596
Practice Address - Country:US
Practice Address - Phone:540-313-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health