Provider Demographics
NPI:1194871327
Name:BRAUKHOFF, JULIE ANNE (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:BRAUKHOFF
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 1:12161 MERCADO DR UNIT 225
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1147
Mailing Address - Country:US
Mailing Address - Phone:719-635-0204
Mailing Address - Fax:303-265-9858
Practice Address - Street 1:12161 MERCADO DR UNIT 225
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1147
Practice Address - Country:US
Practice Address - Phone:719-635-0204
Practice Address - Fax:303-265-9858
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO115227Medicaid