Provider Demographics
NPI:1821175977
Name:COUGHENOUR, JULIE A (MS LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:COUGHENOUR
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:COUGHENOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4652
Mailing Address - Country:US
Mailing Address - Phone:814-323-0958
Mailing Address - Fax:
Practice Address - Street 1:108 HIGH ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2536
Practice Address - Country:US
Practice Address - Phone:814-734-3975
Practice Address - Fax:814-734-3975
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional