Provider Demographics
NPI:1851661623
Name:COLE, JULIETTE LACE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:LACE
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIETTE
Other - Middle Name:LACE
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:416 HIGHLAND AVE
Mailing Address - Street 2:BLDG B
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-440-7798
Mailing Address - Fax:475-775-5015
Practice Address - Street 1:416 HIGHLAND AVE
Practice Address - Street 2:BLDG B
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-440-7798
Practice Address - Fax:475-775-5015
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor