Provider Demographics
NPI:1386482511
Name:MIKULENCAK, JULIE (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MIKULENCAK
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 1:1916 W GRAY ST APT 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4836
Mailing Address - Country:US
Mailing Address - Phone:713-870-5394
Mailing Address - Fax:
Practice Address - Street 1:3129 KINGSLEY DR STE 2050
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8511
Practice Address - Country:US
Practice Address - Phone:346-440-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional