Provider Demographics
NPI:1013664234
Name:CORNELL, JULIETTE D (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:D
Last Name:CORNELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3604
Mailing Address - Country:US
Mailing Address - Phone:502-327-7701
Mailing Address - Fax:502-327-7705
Practice Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3604
Practice Address - Country:US
Practice Address - Phone:502-327-7701
Practice Address - Fax:502-327-7705
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000830106H00000X
KY0168106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist