Provider Demographics
NPI:1205103280
Name:REILLY, JULIA (LCMHC, MLADC, CFC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:REILLY
Suffix:
Gender:F
Credentials:LCMHC, MLADC, CFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRICKETTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2396
Mailing Address - Country:US
Mailing Address - Phone:603-285-1667
Mailing Address - Fax:603-329-4770
Practice Address - Street 1:10 BRICKETTS MILL RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2396
Practice Address - Country:US
Practice Address - Phone:603-285-1667
Practice Address - Fax:603-329-4770
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0676101YA0400X
NH1030101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)