Provider Demographics
NPI:1669894580
Name:MAKDSI, JULIE CHRISTINE (PHD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:CHRISTINE
Last Name:MAKDSI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:CHRISTINE
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:80 INTERSTATE 10 N.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702
Mailing Address - Country:US
Mailing Address - Phone:409-225-5796
Mailing Address - Fax:409-225-5787
Practice Address - Street 1:80 INTERSTATE 10 N.
Practice Address - Street 2:SUITE 205
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702
Practice Address - Country:US
Practice Address - Phone:409-225-5796
Practice Address - Fax:409-225-5787
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70291103TS0200X
TX1-13-15060103K00000X
TX36462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst