Provider Demographics
NPI:1356109110
Name:HALL, JULIA (LPC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 WASHINGTON BLVD APT C1
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3874
Mailing Address - Country:US
Mailing Address - Phone:972-765-0790
Mailing Address - Fax:
Practice Address - Street 1:228 E LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2889
Practice Address - Country:US
Practice Address - Phone:630-835-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health