Provider Demographics
NPI:1124174024
Name:KLECKER, JULIE JEANNINE (LCMHC, LPC, PC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:JEANNINE
Last Name:KLECKER
Suffix:
Gender:F
Credentials:LCMHC, LPC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 MAIN ST STE 37
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-4207
Mailing Address - Country:US
Mailing Address - Phone:336-298-2944
Mailing Address - Fax:
Practice Address - Street 1:11676 PERRY HWY STE 2100
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7203
Practice Address - Country:US
Practice Address - Phone:610-892-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009820101YA0400X, 101YP2500X
NC10138101YA0400X, 101YP2500X
PAPC016231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)