Provider Demographics
NPI:1750894481
Name:EATON, JULIE L (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:EATON
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:KASPAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61654-1346
Mailing Address - Country:US
Mailing Address - Phone:309-671-8000
Mailing Address - Fax:309-671-8039
Practice Address - Street 1:3400 W NEW LEAF LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-3311
Practice Address - Country:US
Practice Address - Phone:309-689-3064
Practice Address - Fax:309-589-1019
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional