Provider Demographics
NPI:1356586127
Name:LEARY, JULIE MAE (LIMHP,LADC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MAE
Last Name:LEARY
Suffix:
Gender:F
Credentials:LIMHP,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2614
Mailing Address - Country:US
Mailing Address - Phone:402-740-6453
Mailing Address - Fax:402-884-1054
Practice Address - Street 1:7317 JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2614
Practice Address - Country:US
Practice Address - Phone:402-740-6453
Practice Address - Fax:402-884-1054
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE840101YA0400X
NE1412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)