Provider Demographics
NPI:1982235222
Name:REILLY, JULIANNE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:REILLY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:MISS
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:LACROCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 E GATE DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2803
Mailing Address - Country:US
Mailing Address - Phone:856-528-2207
Mailing Address - Fax:
Practice Address - Street 1:103 E GATE DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2803
Practice Address - Country:US
Practice Address - Phone:856-528-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00540000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional