Provider Demographics
NPI:1891083093
Name:KUEHNLE, JULIET LAM (LCMHCS)
Entity type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:LAM
Last Name:KUEHNLE
Suffix:
Gender:F
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 ELI ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3122
Mailing Address - Country:US
Mailing Address - Phone:704-412-8830
Mailing Address - Fax:
Practice Address - Street 1:5970 FAIRVIEW RD STE 126
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2100
Practice Address - Country:US
Practice Address - Phone:704-412-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8919101YP2500X
NCS8919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional