Provider Demographics
NPI:1063046894
Name:NESTOR, JULIANNE (LPC)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:NESTOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SHREWSBURY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4931
Mailing Address - Country:US
Mailing Address - Phone:732-530-9029
Mailing Address - Fax:
Practice Address - Street 1:620 SHREWSBURY AVE STE D
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4931
Practice Address - Country:US
Practice Address - Phone:732-530-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00714300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional