Healthcare Provider Details

I. General information

NPI: 1972854123
Provider Name (Legal Business Name): JULIANA MARIE STRAVERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 S HIGLEY RD STE 104
GILBERT AZ
85295-2030
US

IV. Provider business mailing address

243 W JASMINE ST
MESA AZ
85201-1710
US

V. Phone/Fax

Practice location:
  • Phone: 520-492-7602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-19437
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401013098
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0187131
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: