Provider Demographics
NPI:1063535920
Name:GREENE, JULIE K (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:GREENE
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 1:1634 WALNUT ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5400
Mailing Address - Country:US
Mailing Address - Phone:303-554-4705
Mailing Address - Fax:303-661-0009
Practice Address - Street 1:1634 WALNUT ST
Practice Address - Street 2:SUITE 221
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5400
Practice Address - Country:US
Practice Address - Phone:303-554-4705
Practice Address - Fax:303-661-0009
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional