Provider Demographics
NPI:1811045909
Name:RICHARDSON, JULIE ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 MEREDITH DR
Mailing Address - Street 2:STE. B
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2334
Mailing Address - Country:US
Mailing Address - Phone:515-334-9484
Mailing Address - Fax:515-334-9498
Practice Address - Street 1:5525 MEREDITH DR
Practice Address - Street 2:STE. B
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-2334
Practice Address - Country:US
Practice Address - Phone:515-334-9484
Practice Address - Fax:515-334-9498
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health