Provider Demographics
NPI:1649318155
Name:FISCHETTO, JULIA LUCILLE (LMHC)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:LUCILLE
Last Name:FISCHETTO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5208 NE 24 TERRACE
Mailing Address - Street 2:F317
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-491-9040
Mailing Address - Fax:954-492-0334
Practice Address - Street 1:218 COMMERCIAL BLVD
Practice Address - Street 2:SUITE 210H
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-491-9040
Practice Address - Fax:954-492-0334
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0003922101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor