Provider Demographics
NPI:1588160303
Name:SMITH, JULIE MARGARITA (LMHC, CAP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARGARITA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARGARITA
Other - Last Name:CLIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CAP
Mailing Address - Street 1:10075 GATE PKWY N APT 202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4415
Mailing Address - Country:US
Mailing Address - Phone:904-322-1232
Mailing Address - Fax:
Practice Address - Street 1:10151 DEERWOOD PARK BLVD STE 250
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0566
Practice Address - Country:US
Practice Address - Phone:904-906-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5422101YA0400X
FL15745101YM0800X
FLMH15745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)