Provider Demographics
NPI:1821331646
Name:SMITH, JULIA (MAAT, LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MAAT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OXFORD RD
Mailing Address - Street 2:SUITE C1
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3855
Mailing Address - Country:US
Mailing Address - Phone:203-600-8900
Mailing Address - Fax:
Practice Address - Street 1:4 OXFORD RD
Practice Address - Street 2:SUITE C1
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3855
Practice Address - Country:US
Practice Address - Phone:203-615-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional