Provider Demographics
NPI:1083415269
Name:GILL, JULIANNA (LGPC)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:GILL
Suffix:
Gender:
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 EGRET WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-1912
Mailing Address - Country:US
Mailing Address - Phone:301-861-6424
Mailing Address - Fax:
Practice Address - Street 1:211 E FORT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4628
Practice Address - Country:US
Practice Address - Phone:443-708-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health