Provider Demographics
NPI:1811031842
Name:MARKLEY, JULIA KATE (LCSW, PHD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:KATE
Last Name:MARKLEY
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2659
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33806-2659
Mailing Address - Country:US
Mailing Address - Phone:863-701-8881
Mailing Address - Fax:863-701-8882
Practice Address - Street 1:3566 ASHLING DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-5225
Practice Address - Country:US
Practice Address - Phone:863-701-8881
Practice Address - Fax:863-701-8882
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL762161200Medicaid