Provider Demographics
NPI:1841804317
Name:POPE, JULIA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 PRESIDENTIAL DR STE 105
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8021
Mailing Address - Country:US
Mailing Address - Phone:919-402-9622
Mailing Address - Fax:
Practice Address - Street 1:2410 PRESIDENTIAL DR STE 105
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8021
Practice Address - Country:US
Practice Address - Phone:919-402-9622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-26447101YA0400X
NCA15957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)