Provider Demographics
NPI:1265805642
Name:WEEMS, JULIA K (LCSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:WEEMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4363 HENDERSON CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-5926
Mailing Address - Country:US
Mailing Address - Phone:205-427-2887
Mailing Address - Fax:
Practice Address - Street 1:200 PARK CIRCLE DR
Practice Address - Street 2:STE 2
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7628
Practice Address - Country:US
Practice Address - Phone:601-933-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC7361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health