Provider Demographics
NPI:1194923136
Name:TABOR, JULIA HUGHES (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:HUGHES
Last Name:TABOR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2614 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8804
Mailing Address - Country:US
Mailing Address - Phone:336-684-9951
Mailing Address - Fax:336-513-0554
Practice Address - Street 1:2207 DELANEY DR
Practice Address - Street 2:STE 107
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5263
Practice Address - Country:US
Practice Address - Phone:336-684-9951
Practice Address - Fax:336-513-0554
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103650Medicaid