Provider Demographics
NPI:1942473020
Name:PUGGINI, JULIE KRISTEN (LPC)
Entity Type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:KRISTEN
Last Name:PUGGINI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CASS AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2252
Mailing Address - Country:US
Mailing Address - Phone:586-260-7135
Mailing Address - Fax:
Practice Address - Street 1:117 CASS AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2252
Practice Address - Country:US
Practice Address - Phone:586-260-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008044101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional