Provider Demographics
NPI:1134924954
Name:JOHNSON, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WEAVER PARK RD STE 207
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6070
Mailing Address - Country:US
Mailing Address - Phone:970-540-1522
Mailing Address - Fax:
Practice Address - Street 1:255 WEAVER PARK RD STE 207
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6070
Practice Address - Country:US
Practice Address - Phone:970-540-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health