Provider Demographics
NPI:1215642376
Name:CHANDLER, JULIA ROSE (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ROSE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6900 FARMINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-5551
Mailing Address - Country:US
Mailing Address - Phone:704-910-5810
Mailing Address - Fax:980-207-0214
Practice Address - Street 1:6900 FARMINGDALE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5551
Practice Address - Country:US
Practice Address - Phone:704-910-5810
Practice Address - Fax:980-207-0214
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional