Healthcare Provider Details

I. General information

NPI: 1801940796
Provider Name (Legal Business Name): JULIA M LANKTON LPC, LISAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 E MCDOWELL RD SUITE 300
PHOENIX AZ
85006-2664
US

IV. Provider business mailing address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-6567
  • Fax: 602-344-6560
Mailing address:
  • Phone: 602-344-5651
  • Fax: 602-344-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC11857
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC12890
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC12890
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: