Provider Demographics
NPI:1952903593
Name:JULIAN, CHELSEA (LPC-IT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:JULIAN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 LAWRENCE DRIVE
Mailing Address - Street 2:200
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-4710
Mailing Address - Country:US
Mailing Address - Phone:920-245-3484
Mailing Address - Fax:
Practice Address - Street 1:1710 LAWRENCE DRIVE
Practice Address - Street 2:200
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-4710
Practice Address - Country:US
Practice Address - Phone:920-245-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4264101YM0800X
101YP2500X
WI8778-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health