Provider Demographics
NPI:1215633235
Name:VINCI, JULIE ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:VINCI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NW 78TH TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1912
Mailing Address - Country:US
Mailing Address - Phone:954-805-0686
Mailing Address - Fax:
Practice Address - Street 1:10400 GRIFFIN RD STE 107
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3320
Practice Address - Country:US
Practice Address - Phone:954-440-6238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4553106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty