Provider Demographics
NPI:1396992798
Name:STAPLES, JULIE MARIE (MACC, LMFT, LPCA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:STAPLES
Suffix:
Gender:F
Credentials:MACC, LMFT, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 TYVOLA RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3588
Mailing Address - Country:US
Mailing Address - Phone:980-202-1292
Mailing Address - Fax:
Practice Address - Street 1:756 TYVOLA RD
Practice Address - Street 2:SUITE 109
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-3588
Practice Address - Country:US
Practice Address - Phone:980-202-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA812101YP2500X
NC1441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional