Provider Demographics
NPI:1598592735
Name:WARREN, JULIA MICHELLE (MA, LPC-A)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MICHELLE
Last Name:WARREN
Suffix:
Gender:F
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HILLCREEK DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3316
Mailing Address - Country:US
Mailing Address - Phone:903-262-0884
Mailing Address - Fax:
Practice Address - Street 1:3334 S SOUTHWEST LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9237
Practice Address - Country:US
Practice Address - Phone:903-262-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health