Provider Demographics
NPI:1790935039
Name:BIRD, JULIE MILLER (MRC, LPC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MILLER
Last Name:BIRD
Suffix:
Gender:F
Credentials:MRC, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2104
Mailing Address - Country:US
Mailing Address - Phone:864-260-2220
Mailing Address - Fax:864-260-2225
Practice Address - Street 1:115 CARTER PARK DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1152
Practice Address - Country:US
Practice Address - Phone:864-885-0157
Practice Address - Fax:864-882-3974
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5630101Y00000X
SC361101YA0400X
SC107092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)