Provider Demographics
NPI:1528258035
Name:INGBER, JULIE RUTH (LMHC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:RUTH
Last Name:INGBER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13065 QUINCY BAY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7410
Mailing Address - Country:US
Mailing Address - Phone:904-686-5018
Mailing Address - Fax:904-465-5152
Practice Address - Street 1:2344 3RD ST S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4023
Practice Address - Country:US
Practice Address - Phone:904-686-5018
Practice Address - Fax:904-246-5152
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ109WOtherBLUE CROSS BLUE SHIELD