Provider Demographics
NPI:1699436519
Name:WELLS, JULIE (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-1999
Mailing Address - Country:US
Mailing Address - Phone:484-792-1912
Mailing Address - Fax:
Practice Address - Street 1:6712 WASHINGTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-1999
Practice Address - Country:US
Practice Address - Phone:609-889-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00951100101Y00000X
NJ37AC00504300101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor