Provider Demographics
NPI:1811263312
Name:SMITH, JULIANN (PHD, LPC, NCC, CCM)
Entity type:Individual
Prefix:DR
First Name:JULIANN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, LPC, NCC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S MONROE AVE
Mailing Address - Street 2:THE GUINAN CENTER
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-1635
Mailing Address - Country:US
Mailing Address - Phone:540-965-2100
Mailing Address - Fax:540-965-2105
Practice Address - Street 1:311 S MONROE AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-1635
Practice Address - Country:US
Practice Address - Phone:540-965-2100
Practice Address - Fax:540-965-2105
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003272101YP2500X
VA44886101YP2500X
VA06155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701003272OtherLICENSED PROFESSIONAL COUNSELOR - VA
VA06155OtherCERTIFIED CASE MANAGER
VA12514591OtherCAQH
VA44886OtherNATIONALLY CERTIFIED COUNSELOR