Provider Demographics
NPI:1396282893
Name:CANADA, JULIA FIELDS (LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:FIELDS
Last Name:CANADA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:FIELDS
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 BUFORD RD SUITE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235
Mailing Address - Country:US
Mailing Address - Phone:804-447-6382
Mailing Address - Fax:804-447-6383
Practice Address - Street 1:101 BUFORD RD SUITE 110
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-447-6382
Practice Address - Fax:804-447-6383
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health