Provider Demographics
NPI:1063799476
Name:DEROUEN, JULIA ALLISON (MA ED, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ALLISON
Last Name:DEROUEN
Suffix:
Gender:F
Credentials:MA ED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 HAYWOOD KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-8705
Mailing Address - Country:US
Mailing Address - Phone:828-808-7673
Mailing Address - Fax:828-696-2031
Practice Address - Street 1:120 CHADWICK SQUARE CT STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3200
Practice Address - Country:US
Practice Address - Phone:828-696-2667
Practice Address - Fax:828-696-2031
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8835OtherLICENSE PROFESSIONAL COUNSELOR