Provider Demographics
NPI:1942785480
Name:JULIANA, ELEONORA V (PHD, LMFT, LAC)
Entity Type:Individual
Prefix:MRS
First Name:ELEONORA
Middle Name:V
Last Name:JULIANA
Suffix:
Gender:F
Credentials:PHD, LMFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6795 E TENNESSEE AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1693
Mailing Address - Country:US
Mailing Address - Phone:720-203-2887
Mailing Address - Fax:
Practice Address - Street 1:6795 E TENNESSEE AVE
Practice Address - Street 2:SUITE 185
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1653
Practice Address - Country:US
Practice Address - Phone:720-203-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001170101YA0400X
COLMFT.0001836106H00000X
101YM0800X
COMFT.0001836106H00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000169697Medicaid