Provider Demographics
NPI:1821859729
Name:JULIA CRUMRINE PHD CLINICAL PSYCHOLOGIST LLC
Entity Type:Organization
Organization Name:JULIA CRUMRINE PHD CLINICAL PSYCHOLOGIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NICHOLSON CRUMRINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HSPP
Authorized Official - Phone:219-707-8515
Mailing Address - Street 1:970 MILLPOND RD STE C
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-6273
Mailing Address - Country:US
Mailing Address - Phone:219-707-8515
Mailing Address - Fax:219-386-2253
Practice Address - Street 1:970 MILLPOND RD STE C
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-6273
Practice Address - Country:US
Practice Address - Phone:219-707-8515
Practice Address - Fax:219-386-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty