Provider Demographics
NPI:1194052985
Name:JULIE B. BEAN, LLC
Entity type:Organization
Organization Name:JULIE B. BEAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-961-8173
Mailing Address - Street 1:85 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-5514
Mailing Address - Country:US
Mailing Address - Phone:860-961-8173
Mailing Address - Fax:
Practice Address - Street 1:85 BROOK ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-5514
Practice Address - Country:US
Practice Address - Phone:860-961-8173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty